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Counterforce Follow Up
Thank you so much for using Counterforce Health to appeal your health insurance denial! Our mission is made sustainable by research grant funding, which depends on hearing from participants like yourselves and your experience with the tool.
What was your appeal outcome?
*
A
I won
B
I was denied
C
Other
Date of birth
*
Sex / Gender
*
A
Male
B
Female
What is your race and/or ethnicity? (Select all that apply)
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White
Prefer not to answer
Is the claim your submitting related to cancer treatment, or anything related to cancer?
*
A
Yes
B
No
Submit
