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2014
September
P
Pain Qs
Pain Qs
0%
Exit Survey
What is your gender?
Male
Female
What is your age?
Younger than 18
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
Prefer not to answer
What is the highest level of education you have achieved?
Less than high school degree
High school degree or equivalent (e.g. GED)
Some college but no degree
Associate degree (e.g. AA, AS)
Bachelor's degree (e.g. BA, AB, BS)
Master's degree (e.g. MA, MS, MBA)
Professional degree (e.g. MD, DDS, JD)
Doctorate degree (e.g. PhD)
Which category best describes your annual income?
Under $15,000
$15,000 - $29,999
$30,000 - $44,999
$45,000 - $59,999
$60,000 - $74,999
$75,000 - $89,999
$90,000 - $104,999
$105,000 - $119,999
$120,000 or more
Prefer not to answer
How many children do you have?
no children
1 child
2 children
3 children
more than 4 children
What is your marital status?
Single (Never married)
Married
Domestic partnership
Widowed
Divorced
Separated
Don’t know
How satisfied are you with the following:
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
N/A
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