Patient Perspective Financial Impact
Impression of Financial Impact
| A very significant impact | 0 |
| A somewhat significant impact | 0 |
| A minor impact | 0 |
| I’m not sure | 0 |
| No impact | 0 |
| I’d rather not say | 0 |
| Not answered | 0 |
HOW WAS TREATMENT PAID FOR
| Public Patient | 0 |
| Private Health Insurance | 0 |
| Privately Funded | 0 |
| Not Answered | 0 |
Financial Impact – Private Insurance
| Less than $10,000 | 0 |
| $10,000 – $20,000 | 0 |
| $20,000 – $40,000 | 0 |
| $40,000 – $60,000 | 0 |
| $60,000 – $80,000 | 0 |
| $80,000 – $100,000 | 0 |
| More than $100,000 | 0 |
| I’m Not Sure | 0 |
| I’d rather not say | 0 |
Total Estimated Financial Impact (Private Insurance): $0
Financial Impact of treatment
| Less than $10,000 | 0 |
| $10,000 – $20,000 | 0 |
| $20,000 – $40,000 | 0 |
| $40,000 – $60,000 | 0 |
| $60,000 – $80,000 | 0 |
| $80,000 – $100,000 | 0 |
| More than $100,000 | 0 |
| I’m Not Sure | 0 |
| I’d rather not say | 0 |
| Not answered | 0 |
Total Estimated Financial Impact: $0
Financial Impact – Public Patient
| Less than $10,000 | 0 |
| $10,000 – $20,000 | 0 |
| $20,000 – $40,000 | 0 |
| $40,000 – $60,000 | 0 |
| $60,000 – $80,000 | 0 |
| $80,000 – $100,000 | 0 |
| More than $100,000 | 0 |
| I’m Not Sure | 0 |
| I’d rather not say | 0 |
Total Estimated Financial Impact (Public Patient): $0
Estimated Loss of Income *
| Less than $10,000 | 0 |
| $10,000 – $20,000 | 0 |
| $20,000 – $40,000 | 0 |
| $40,000 – $60,000 | 0 |
| $60,000 – $80,000 | 0 |
| $80,000 – $100,000 | 0 |
| $100,000 – $200,000 | 0 |
| More than $200,000 | 0 |
| I’m not sure | 0 |
| I’d rather not say | 0 |
| Not answered | 0 |
Total Estimated Loss of Income: $0
Financial Impact – Privately Funded
| Less than $10,000 | 0 |
| $10,000 – $20,000 | 0 |
| $20,000 – $40,000 | 0 |
| $40,000 – $60,000 | 0 |
| $60,000 – $80,000 | 0 |
| $80,000 – $100,000 | 0 |
| More than $100,000 | 0 |
| I’m Not Sure | 0 |
| I’d rather not say | 0 |
Total Estimated Financial Impact (Privately Funded): $0