ACP Heart Failure Survey Question Title * 1. Gender Male Female Question Title * 2. Age Under 18 18-34 35-54 55+ Question Title * 3. How long have you been diagnosed with heart failure? Less than one month 1-6 months 7 months - 1 year 1-5 years 6+ years Question Title * 4. How did you learn about the Heart Failure Guide? Health Plan Hospital Outpatient Clinic Employer Other (please specify) Question Title * 5. How would you rate overall satisfaction with the Heart Failure Guide? Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied Question Title * 6. I have a better understanding of my condition as a result of reading the Heart Failure Guide. Strongly agree Agree Neutral Disagree Strongly disagree Question Title * 7. I feel more confident about managing my condition as a result of reading the Heart Failure Guide Strongly agree Agree Neutral Disagree Strongly disagree Question Title * 8. I will use ideas from the Heart Failure Guide to help improve my health. Strongly agree Agree Neutral Disagree Strongly disagree Question Title * 9. In what ways has the Heart Failure Guide helped you manage your condition? Understanding heart failure Monitoring heart failure Healthier eating/dieting Getting more exercise Understanding the risk factors Understanding and using your medication Feeling better about your condition Question Title * 10. What changes or improvements would you make to the Heart Failure Guide? Question Title * 11. Do you have any additional comments? Done