This free survey is powered by
0%
Exit Survey
 
 
Hello:
You are invited to participate in our survey [HEALTH SURVEY]. In this survey, approximately 500 people will be asked to complete a survey that asks questions about family details and related health issues. It will take approximately two-three minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Bharath Niranjan at 919833623975 or by email at [email protected]

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
Total family members
 
One
 
Two
 
Three
 
Above Three
 
 
 
Family Member above 50 years of age and below 10 years of age
 
One
 
Two
 
Three
 
Above Three
 
 
 
Which category best defines your annual income?
 
2.5 to 5.0 Lakhs
 
5.0 to 7.5 Lakhs
 
7.5 to 10.0 Lakhs
 
Above 10 Lakhs
 
 
 
Frequency of hospital visits in a month
 
Once
 
Twice
 
Thrice
 
More than three times
 
 
 
Have you or your family members felt the need for professional medical help immedialtely?
 
Yes
 
No
 
 
 
In case of emergency,would you prefer medical assistance in the first
 
Five Minutes
 
Fifteen Minutes
 
More than fifteen minutes
 
 
 
Which of the following categories best describes the industry you work in?
 
Automotive
 
Advertising
 
Consulting Services
 
Education
 
Entertainment
 
Financial Services
 
Government Services
 
Healthcare
 
Human Resources
 
Information Technology
 
Marketing/Sales
 
Non-Profit
 
Pharmaceuticals
 
Public Relations
 
Technical Services
 
Travel
 
Other