FEEDBACK FORM
Please provide any feedback you have about this site. This website was created as part of a research study funded by the Agency for Healthcare Research and Quality, and your feedback will be an important part of this research. If you have any questions or comments about this research study, please contact the Principal Investigator, Dr. Ajay Israni, at 612-873-6987.
By completing this feedback form, you are consenting to have your responses recorded as part of the research study.
- 1) What organ type are you searching for on this site? *requiredSelect all that apply
- 2) How useful is the information in the report card in helping you choose a transplant center for you or your family?Select your choice
- 3) Are you a:Select your choice
- 4) If you are a patient or a family member/friend of a patient seeking an organ transplant, please indicate the wait list status of the patient:Select your choice
- 5) Have you discussed the information shown on this website with a medical provider?Select your choice
- 6) Will you allow a qualified researcher conducting this study to contact you in the future to ask if you want to provide more information about the usefulness of this website?Select your choice
- Please provide any other feedback you have about the website.