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Health Plan Users Dependents Mapping Survey

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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1

What is the relationship between you and the health plan user?

Select the option that best describes your relationship with the health plan user
2

Rate the quality of the multiprofessional follow-up received by the health plan user

Rate the quality of the follow-up from 1 to 10, where 1 is very poor and 10 is excellent
3

Please describe any challenges faced in accessing multiprofessional care for the health plan user

Provide a detailed description of the challenges faced in accessing multiprofessional care
4

How satisfied are you with the information provided by the health plan regarding services for dependents with disabilities?

Rate your satisfaction level from 1 to 5, where 1 is very dissatisfied and 5 is very satisfied
5

Do you believe the health plan adequately covers the required services for dependents with disabilities or neurodevelopmental disorders?

Provide your opinion on whether the health plan covers the necessary services
6

How often do you communicate with the health plan user's healthcare providers?

Select the frequency of your communication with the healthcare providers
7

Rate the effectiveness of the treatments received by the health plan user for their condition

Rate the effectiveness of treatments from 1 to 10, where 1 is not effective at all and 10 is extremely effective
8

In your opinion, what improvements could be made to the health plan's multiprofessional care services?

Provide suggestions for enhancing the multiprofessional care services
9

How well do you understand the health plan coverage for dependents with disabilities or neurodevelopmental disorders?

Indicate your level of understanding regarding coverage for dependents with disabilities
10

Do you feel supported by the health plan in managing the care of the dependent with disabilities or neurodevelopmental disorders?

Share your feelings about the support provided by the health plan in care management
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