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ProvidenceEnglish

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Welcome to the Providence 2016 Cinco de Mayo Survey
 
 
What is your age?
 
18-24
 
25-31
 
32-38
 
39-45
 
46-52
 
52-59
 
60+
 
 
What is your gender?
 
Male
 
Female
 
 
What is your ethnicity? (Select all that apply)
 
American Indian or Alaska Native
 
Asian
 
Black/African American
 
Hispanic/Latino
 
Middle Eastern or Indian
 
Native Hawaiian or Pacific Islander
 
White/Caucasian
 
Other
 

 
 
What's the highest level of education you have achieved?
 
Elementary School
 
Middle School
 
High School
 
Some College
 
Bachelor's Degree
 
Masters or higher
 
Other
 
 
 
What is your household's annual income?
 
Less than $15,000
 
$15,001-$25,000
 
$25,001-$35,000
 
$35,001-$50,000
 
$50,001-$75,000
 
More than $75,000
 
 
What is your area of occupation?
 
Homemaker
 
Student
 
Government
 
Construction
 
Food or Service Industry
 
Retail, Sales or Marketing
 
Healthcare or Technology
 
Business Owner
 
Agriculture
 
Retired
 
Unemployed
 
Nonprofit or Education
 
Other
 
 
 
Do you have health insurance?
 
Yes
 
No
 
 
 
Do your kids have health insurance?
 
Yes
 
No
 
I don't have kids
 
 
In thinking about what matters when selecting a health care provider or caregiver, to what extent are the following issues important? Please select your response for each item.
Not at all Rarely Somewhat Very Much
Distance from home or work
Hours that care is available
Relationship with provider or care team
Out of pocket cost
Recommendations from friends, family or trusted sources
The provider or care team speaks my language
The provider or care team is knowledgeable of my culture
Issues of privacy or confidentiality
Services and information are available in my language
 
 
In thinking about what matters when choosing a health insurance plan, to what extent do the following factors matter? Please select your response for each item.
Not at all Rarely Somewhat Very Much
Familiarity with name or brand
Brand or provider is active or is supportive of my community
Agents and staff reflect the diversity of my community
Out of pocket costs
Recommendations from friends, family or trusted sources
The provider or care team speaks my language
The provider or care team is knowledgeable of my culture
Range of benefits
Number of providers in my area
Services and information are available in my language
 
 
 
Thank you for your participation! Please complete the survey by pressing "Next"