What is the Impact of COVID-19 on Lymphedema Patients?
The purpose of this informal survey is to asses the impact of the COVID-19 pandemic on lymphedema patients, both directly and indirectly. Information obtained here may be used by the Lymphedema Advocacy Group in communications with congressional offices to support passage of the Lymphedema Treatment Act, but will not be shared or utilized in any other way. For more information or to contact us please visit LymphedemaTreatmentAct.org.
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Your First and Last Name *
Your Phone Number *
Your Street Address (optional, but in cases where zip codes are split between multiple congressional districts we will not be able to confirm yours without it)
Your City *
Your State *
Your Zip Code *
Relationship to Lymphedema (Please select all that apply, but when responding to the remaining questions  be clear from which perspective you are speaking.) *
Required
The remaining questions are geared towards patients. If you are a clinician, family member, etc., please answer on the patient's behalf or from your own perspective.  Thank you for sharing this valuable feedback!
All questions require a response, but you can simply write "skip" or "n/a" if you are either not comfortable answering a specific question or if it does not apply to you.  
What is your age? (Clinicians please list the range or typical age of your patients.) *
Do you have any other serious or chronic health conditions besides lymphedema? If so, please list them if you are comfortable with that. *
Has any medical professional advised you to take any extra precautions (beyond what has been advised for all people) due to your lymphedema? If so, please explain. *
Are you more worried about your ability to effectively manage your lymphedema due to current circumstances? If yes, please explain. *
If you or a family member were to contract the coronavirus, how would it or how might it impact your ability to manage your lymphedema? *
Are you already experiencing any increased difficulty in managing your lymphedema? If so, please explain. *
Have you or anyone close to you already contracted the coronavirus? If so, what impact has it had on your ability to manage your lymphedema, or how concerned are you that it might impact it in the future? *
Do you have any doctor or therapy appointments that have either been cancelled by the facility or you? If so, please explain. *
Have you been unable to purchase compression garments or supplies due to loss of income, or out of concern for future loss of income? *
What type of insurance do you have? (If you are double insured please select your primary insurance policy.) *
Please select any secondary insurance policy. *
Does your insurance plan (or your primary plan if double insured) currently provide any coverage for your compression garments and supplies? *
Does your secondary insurance plan currently provide any coverage for your compression garments and supplies? *
Has lack of insurance coverage or insufficient coverage for your compression garments and supplies negatively impacted your life and/or ability to manage your lymphedema? *
Knowing that Medicare currently has no coverage for compression garments and supplies, how concerned are you about your ability to manage your lymphedema now that you are on Medicare, or once you reach Medicare age? *
Is there anything else you would like to tell us that you think would be helpful in persuading lawmakers that it's more important than ever to enact preventative healthcare bills like the Lymphedema Treatment Act, which enable patients to manage their condition at home and reduce the incidence of complications and lymphedema-related hospitalizations? *
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