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WOMHA 2016 Feedback Questionnaire
The WOMHA board would like to know your opinions or advice. Please complete the brief survey. If you prefer to remain anonymous, you do not have to include your name and contact information.
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Name
Your answer
Best way to contact you-Please provide email or telephone number
Your answer
Please rate how important the following topic is for WOMHA to focus on---Continuing Education
Least Important
1
2
3
4
5
Most important
Clear selection
Please rate how important the following topic is for WOMHA to focus on--Insurance Contracts
Least Important
1
2
3
4
5
Most Important
Clear selection
Please rate how important the following topic is for WOMHA to focus on--Lobbying for Fair Reimbursement Rates
Least Important
1
2
3
4
5
Most Important
Clear selection
Please rate how important the following topic is for WOMHA to focus on--Professional Collaboration
Least Important
1
2
3
4
5
Most Important
Clear selection
Please list any other area that you think WOMHA should focus on
Your answer
Which insurance companies would you like us to focus on next for a contract?
Your answer
Would you be interested or do you think it would be beneficial for WOMHA to have an informal monthly "open forum" for members to ask questions, receive assistance with CarePaths, etc.?
Yes
No
Other:
Clear selection
What suggestions or ideas do you have for building WOMHA membership?
Your answer
What topics or presenter suggestions do you have for half day CEUs?
Your answer
What topic or presenter suggestions do you have for full day or longer CEUs?
Your answer
What ideas do you have for keeping WOMHA strong and innovative?
Your answer
What do you like most about WOMHA?
Your answer
What are your concerns about WOMHA?
Your answer
WOMHA needs volunteers to help! Please indicate an area where you would be willing to assist?
WOMHA Board Member
Membership Recruitment
Contract Negotiation or Review
Website Administrator
Special Committee or Project Assignment
Grant Writing
ScreeningWare Tutoring
Continuing Education
Call Center Liasion
Other:
Clear selection
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