How would you rate your overall experience with HMO's?
EXCELLENT
GOOD
FAIR
POOR

Please describe any serious problems you have had with HMO's and list any suggestions you have to prevent others from having similar problems.

PROBLEM:   (And ways to prevent it)    
PROBLEM:   (And ways to prevent it)    

Please send the above information even if you do not want to identify yourself.
     First Name:  Last Name:

     Address:

     City/State/Zip:

     County:

     Phone: Day/Evening: