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2017 CAFP Demographic Survey

CAFP Demographic Survey

1. What is your AAFP member ID? *This question is required.

2. What is the name of your practice or employer, if applicable?

3. Please describe your PRIMARY practice mode. *This question is required.

4. In addition to the clinical information collected in the AAFP Census, we'd like to find out if you perform any of these. Please check all that apply.

5. Approximately what percentage of your patients are: *This question is required.

Medi-Cal fee for service:
Medi-Cal Managed Care:
Medicare - Fee-for-Service or Medicare Advantage:
Privately Insured Fee-for-Service:
Privately Insured Managed Care:
Uninsured:

6. Do you accept patients with Covered California? *This question is required.

7. If you accept Medi-Cal patients:

8. If you do not see Medi-Cal patients, please select the TOP TWO reasons why not:

Not many patients in my area
Administrative hassle
Delays in payment
Payment rates
Other - Write In Please enter an 'other' value for this selection.

9. What is your number one reason for maintaining your membership in CAFP? *This question is required.

10. Please use this space to give us any feedback about your CAFP membership. For example, is there a service you need that is not being provided by CAFP/AAFP?