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Brant Positive Action on HealthCare in Brant -Brantford - Six Nations

The cost of delvering health care has doubled over the last 10 years . We are interested in what the real local costs of healthcare are and how they effect you in your community

What does it cost to stay at the hospital ? * We are trying to determine what the health costs are in our community daily bed rate -ward daily bed rate -single room daily rate end of life other

What were you charged * How much did it cost and who paid for the service?

What do you think the service costs? * If you have stayed at the hospital what was the daily charge -for a ward bed or a single bed ?

What other hospital charges did you pay?

What other non hospital services did you pay for?

• TV rental
• Parking
• Tim Hortons/snacks
• Gifts/ personal sundry items
• non covered medications
• non covered medical services

What was your total cost for a stay at the hospital? What you were billed by the hospital and what you/your visitors paid personally

How long did you stay /your average cost of staying? what was your daily cost to stay at the hospital and those of your visitors

A hospital spokesman said the average costs per bed stay was : the daily bed rate for a single room is $195; $175 for semi private; is this your experience? * What is the true cost of a bed at the hospital in your experience ?

What are your comments and suggestions ? How would you improve services at the hospital?

Can we use your information for action * We respect your privacy

• please use/with name
• please use/without name
• please use with name and keep me posted
• for your use only

Name Email of contact information * Your contact information please

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