Medical Debt Survey

Name

ZIP Code

Postal code

Mobile phone

Which hospital chain is harassing you for unpaid bills: Providence Saint Joseph Health Trinity Health Mass General Brigham The Cleveland Clinic Health System University of Pittsburgh Medical Center University of Pennsylvania Health System Catholic Health Initiatives Advocate Aurora Health Dignity Health Ascension Health

Other (Name of hospital)

What is your insurance status? Insured Underinsured Uninsured I don't know

Has there been any legal action? Yes No

Are you in collections or otherwise being sued? Yes No

Please share your story here:

Medical Debt Survey

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