Case Management Member Satisfaction Survey

1. Name of your Kepro Case Manager          *This question is required.

• Melanie
• Leah
• Suzanne
• Melodie
• Tierra
• Other - Write In Please enter an 'other' value for this selection.

2. I used the Language Interpretation Services to talk to my Case Manager
  *This question is required.

• No
• Yes
• If Yes: Please Identify the language Please enter an 'other' value for this selection.

3. The reason for Case Management was
  *This question is required.

• Pharmacy Issues
• Multiple Issues
• Payment or Claims Issues
• Transportation Issues
• Facility Discharge
• Community or At Home Birth
• Resources
• Other - Write In Please enter an 'other' value for this selection.

4. My age group *This question is required.

• 17 & under
• 18-34
• 35-54
• 55 & older

5. I belong to  *This question is required.

• Native American
• Dual Eligibility
• Veteran
• Medically Frail
• Open Card
• Community Birth

6. The Case Manager helped me to find the services I need *This question is required.

• Yes
• No
• Other - Write In Please enter an 'other' value for this selection.

7. I was able to speak openly with my Case Manager *This question is required.

• Yes
• No
• Other - Write In Please enter an 'other' value for this selection.

8. Would you recommend our Case Management services to others?
  *This question is required.

• Very likely
• Likely
• Less likely Please enter an 'other' value for this selection.
• Unsure
• N/A