We value your feedback.

Albany Med Health System is proud of its role in the area as the only locally governed health system. While we are fully grounded in our history, we are also innovative and looking toward our future. Which is why we invite you to take this survey. The information you provide will help us to continue to provide compassionate care, educate the physicians of tomorrow, and foster discovery through leading-edge biomedical research for years to come.

Step 1 of 12 - Q1

Comments

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1) Do you believe in Albany Medical Center and Albany Medical College's mission to improve health by attaining the highest standard of quality in care delivery, education, and research initiatives?

Yes

2) In what ways have you engaged with Albany Medical Center or Albany Medical College? Please select all that apply.

I donate to Albany Medical Center or Albany Medical College.

I was a patient at Albany Medical Center.

A friend or family member was a patient at Albany Medical Center.

I studied at Albany Medical College.

A friend or family member studied at Albany Medical College.

I am a current or former employee of Albany Medical Center or Albany Medical College.

I have attended events for Albany Medical Center or Albany Medical College.

I follow on social media.

I have visited the website.

Other

2a) Other - Please specify:

Please specify:

2b) How frequently do you engage with Albany Medical Center or Albany Medical College?

Weekly

Monthly

Every few months

Yearly

Rarely or never

Other

2b-i) Other - Please specify:

Please specify:

3) We like to send supporters like you occasional emails with updates including videos, stories, and information about how we are making an impact on your behalf. Would you like to receive these updates? (You can opt out at any time).

Yes I want to receive occasional emails with updates.

Not at this time.

4) Which aspects of the Albany Medical Center and Albany Medical College's work are most meaningful to you?

Please rank the following according to their importance to you, with First Priority being your highest priority.

You may only select one answer for each option.

First Priority	Second Priority	Third Priority

The Albany Medical Center's commitment to providing the highest quality of care close to home.

First Priority

Second Priority

Third Priority

Educating the next generation of physicians and scientists.

First Priority

Second Priority

Third Priority

Albany Medical College's leading edge basic and translational research on a wide variety of health issues.

First Priority

Second Priority

Third Priority

5) Was there an influential person in your life who inspired your appreciation of Albany Medical Center and Albany Medical College?

Yes

5a) If yes, please indicate their relationship to you.

If yes, please indicate their relationship to you.

Parent/grandparent

Spouse/partner/significant other

Child/children

Other family member

Friend

Teacher or professor

Other

5a-i) Other - Please specify:

Please specify:

6) When thinking about future generations, how important is it to you that Albany Medical Center and Albany Medical College continue to improve health by attaining the highest standard of quality in care delivery, education, and research initiatives?

Of utmost importance

Very important

Somewhat important

Not very important

Not important at all

7) Supporters often recognize the need to support Albany Medical Center and Albany Medical College in the following ways. Would you consider furthering our work in any of the following ways?

I already have	I am likely	I am somewhat likely	I am not likely

Donating online with a credit card

I already have

I am likely

I am somewhat likely

I am not likely

Mailing a check

I already have

I am likely

I am somewhat likely

I am not likely

Talking with a gift officer face-to-face or on the phone about making a substantial impact

I already have

I am likely

I am somewhat likely

I am not likely

Making a recurring contribution

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Donor-Advised Fund

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Family Foundation

I already have

I am likely

I am somewhat likely

I am not likely

Giving appreciated assets (such as personal or business stocks or bonds, land or rental real estate, etc.)

I already have

I am likely

I am somewhat likely

I am not likely

Transferring a portion of my IRA account to Albany Medical Center or Albany Medical College (Qualified Charitable Distribution)

I already have

I am likely

I am somewhat likely

I am not likely

Making a charitable gift that provides a lifetime income to me or my loved ones

I already have

I am likely

I am somewhat likely

I am not likely

8) Many people like to include a gift to charity in their will or estate plan to support causes that are important in their life. Would you consider including a gift to Albany Medical Center or Albany Medical College to improve health by attaining the highest standard of quality in care delivery, education, and research initiatives?

I have included a gift for Albany Medical Center or Albany Medical College in my will, trust, or by beneficiary designation.

I am interested in making this type of gift to Albany Medical Center or Albany Medical College.

Not now, but in the future I would definitely be interested in making this type of gift to Albany Medical Center or Albany Medical College.

Not now, but in the future I might possibly be interested in making this type of gift to Albany Medical Center or Albany Medical College.

I am not interested in this type of gift.

8a) Please tell us about your legacy gift:

Please tell us about your legacy gift:

I planned this gift in honor or in memory of someone.

I would like this gift to go to a specific purpose.

Albany Med Health System may use this gift where it will do the most good.

8a-i) Please provide the name of and/or association with this person:

Please provide the name of and/or association with this person:

8a-ii) Please describe the intended purpose:

Please describe the intended purpose:

Would you like us to provide additional information to help with your decision?

Easy Ways to Create Your Legacy

Smart Ways to Make an Impact Now

Gifts that Pay You Income

Tax-Wise Ways to Make an Impact

How to Create or Update Your Estate Plans

9) How do Albany Medical Center and Albany Medical College rank in comparison to other nonprofits you may support?

My top choice for charitable giving

Near the top of my list

Middle of my list

Bottom of my list

Not on my list

9a) Do you have any friends/colleagues/family members with similar interests who would consider supporting the mission and vision of Albany Med Health System?

Do you have any friends/colleagues/family members with similar interests who would consider supporting the mission and vision of Albany Med?

Yes

9a-i) Please let us know the most convenient way to connect:

Please let us know the most convenient way to connect:

I would like to introduce the person(s) to Albany Med Health System on my own.

I would like Albany Med Health System to provide me with resources to share with the person(s).

10) We would love to hear your story. If you would like, please share a special memory or experience with Albany Medical Center or Albany Medical College.

11) About You (optional)

Age

Under 40

40 - 49

50 - 59

60 - 69

70 - 79

80 - 89

90+

Birthdate

MM slash DD slash YYYY

Gender

Male

Female

Nonbinary

Other

Prefer not to specify

Please specify:

What is your marital status?

Married

Not married

Divorced

Widowed

Spouse name

Which of the following best describes your family?

No children

One child

Two or more children

Please tell us the highest level of education you completed:

High school graduate or equivalent

Some college

Associate's degree

Bachelor's degree

Advanced degree

Please select the option(s) that best describes your professional life.

Working full time

Working part time

Retiring within 5 years

Retired

Volunteering

Board member for a nonprofit

Business owner or entrepreneur

Self-employed

Disabled

Other

Where do you serve as a board member?

Please specify your profession:

Please check the box below if you would like to update your contact information.

I would like to update my contact information.

First name(Required)

Last name(Required)

Address

Address 2

City

State

ZIP

Country

Phone

Email(Required)

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