Thank you for helping us improve BMC.org!

Your valuable input is integral to our mission of enhancing the care experience for both you and and our community. Please take a moment to answer a few questions. If you don't feel comfortable answering a particular question, just leave it blank.

What is your full name?

Phone

How old are you?

17 years old and under18 - 30 years old31 - 45 years old36 - 64 years65 years and older

What is your primary language?

What is your proficiency level in the English language?

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How frequently do you receive medical care?

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Is or was any of this medical care at Boston Medical Center?

YesNo

How comfortable do you feel with using technical equipment such as webcams, microphones, and cellphones that may be necessary for a user-testing session?

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Please select which user-testing activities you feel comfortable participating in (select all that apply):

Individual interviewGroup interviewCompleting tasks within a draft version of the websiteNavigating and clicking within a draft version of the websiteAnswering survey questionsAll of the above

Are you comfortable being contacted by BMC as a follow up to this survey?

YesNo

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