If you are a Physician Partner with one of IASIS Healthcare’s hospitals, please take a moment to complete the following quick survey so that we know how to reach you with information and advocacy opportunities about this physician-ownership issue and other issues in the future.  Thank you for your time.

Completed By: Hospital:

How closely have you been following the proposed Congressional ban on physician-owned hospitals?

What is your interest level in this hospital physician-ownership issue?

How willing are you to assist our efforts to oppose the attempted ban on physician-owned hospitals and restrictions on future growth of grandfathered physician-owned hospitals?

In what ways are you willing to assist our efforts to gain support for this issue? Talk to local physicians Talk to elected officials Talk to media Go to D.C.

Do you know or have any personal relationship with any member of the U.S. Senate or House? Yes No If yes, who:

Are you a member of any of the following associations? PHA AMA other If other, please specify:

Please provide any of the following contact information so that we can keep you up to date: Office Address: Home Address: Perferred Phone #: Fax #: E-mail Address:

How would you like IASIS Healthcare and your hospital to communicate with you about this and other matters of interest (be sure to provide this contact information above)? Office Mail Home Mail Phone Fax E-mail