Healthcare-NOW is launching an ambitious project to interview people across the country about their experiences with the US healthcare system. We want to hear about your challenges accessing and paying for care, dealing with doctors and hospitals, and getting the care you need!

Please answer the following questions about you and your household or immediate family. You can respond anonymously or include your name and contact information so we can follow-up with the results of the Census. We will never share your information publicly without your permission.

If you would prefer not to answer any of the questions, just let me know and we'll skip that one.