We want to hear from you!

Will you spend a few minutes of you time to complete this short survey?

Your feedback is very important to us so that we can better serve you.

1. In what ways have you been involved with our MemorialCare Long Beach hospitals or Foundation? (Please check all that apply).
2. Please check the box that best represents your level of interest in the following hospital or Foundation funding priorities:
Long Beach Medical Center
Miller Children’s & Women’s Hospital Long Beach
Cherese Mari Laulhere Children’s Village
MemorialCare Todd Cancer Institute
Jonathan Jaques Children’s Cancer Institute
MemorialCare Heart & Vascular Institute
Neonatal Intensive Care Unit (NICU)
Cherese Mari Laulhere BirthCare Center
Cherese Mari Laulhere Pediatric Intensive Care Unit
Stroke Care
Orthopedic Care
Spinal Care
Rehabilitation Services
3. Please check the box that best represents how important each of the following factors would be if you were to consider making a gift to one of our MemorialCare Long Beach hospitals or Foundation:
Personal satisfaction of giving
Giving back because I was/know someone who was a patient
Support the health and well-being of Long Beach and surrounding communities
Making an impact on patients’ lives
Making high-quality health care easier to access and more affordable
Knowing how my gift is making a difference
Immediate tax advantages
Potential income, tax, and financial benefits
Honor or tribute gifts
4. In the past, have you made a financial contribution to our MemorialCare Long Beach hospitals or Foundation?
5. Please check the box that best represents your level of satisfaction with our MemorialCare Long Beach hospitals’ or Foundation’s performance regarding your gift:
I was thanked promptly for my contributions
I have received a personal call or visit
My contribution(s) was recognized appropriately
I was able to designate how my donations were used
I was kept information about the use of foundation funds
I trust the hospitals or Foundation to use donations appropriately
6. What should our MemorialCare Long Beach hospitals or Foundation do better to serve your needs or exceed your expectations?
7. Was there someone in your life who was particularly influential in shaping your views on health care?
8. Many people like to leave one or more gifts to charity in their will. If you were to sign a will in the next six months, how likely would you be to include a gift to our MemorialCare Long Beach hospitals or Foundation?
9. (Please check all that apply). I have designated the following as a gift(s) in my estate plan:
10. Which one of the financial benefits listed below would be the most important to you if you were to consider making a charitable gift?
11. Please provide your contact information.

We would like to celebrate you on your birthday.
Please provide your birthday and we will send you a birthday card on your birthday month.
 

12. How do you prefer to be addressed?
13. How do you prefer to receive information about our MemorialCare Long Beach hospitals or Foundation? (Please check all that apply).
14. Please contact me about making a gift to Long Beach Medical Center or Miller Children’s & Women’s Hospital Long Beach.
15. For demographic purposes only, please provide the following information about yourself:
What is your marital status?
What is your age?
What is your spouse’s age (if married)?
Do you have children?
Do you have grandchildren?
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Thank you for completing this survey!

We appreciate you taking the time in completing this survey and we appreciate your feedback.

The information you provide will be kept confidential for our internal use only.

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