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Surveys
2017
May
E
Eye consultation survey
Eye consultation survey
0%
Questions marked with a
*
are required
Exit Survey
*
1. How is your vision?
Correct, never used glasses
Not correct, use glasses or lens
Corrected in the past, by surgery or treatment
I do not want to reveal
Any other issue
*
2. Do you or a close relative of yours suffer from an eye problem that needs attention?
Yes
No
*
3. How many times do you visit an eye specialist in a year?
None
1-3
4-6
More than 6
*
4. Do you check online sources for your eye problems before consultation?
Almost always, >80% of cases
Often, 50%-80% of cases
Sometimes, 10%-50% of cases
Seldom, <10% of cases
Other
*
5. Do you check online sources after consultation for a second opinion?
Almost always, >80% of cases
Often, 50%-80% of cases
Sometimes, 10%-50% of cases
Seldom, <10% of cases
Other
*
6. If there was a reliable (approved by renowned eye specialty hospitals) online source available for eye related problems, would you be interested in referring it as a second opinion for yourself or a close relative? Check all that applies
Yes, for second opinion on diagnosis and treatment
Yes, for best known treatment to the problem
Yes, for future vision related changes and consequences
No, I have all that I need available online
No, I trust doctors more than online sources
*
7. How much would you pay at maximum for an online consultation specific to your problems?
Nothing, I trust doctors only for consultation
Rs.10
Rs.20
Rs.30
Other
*
8. How many times in a year do you accompany your relative visiting an eye hospital?
Almost never
1-2
3-4
More than 4
*
9. If there is a kiosk based eye checker (
link
) available in hospitals where you can enter details of eye test results and get consultation regarding diagnosis, treatment and outcomes, would you be interested in going for a second opinion?
Yes
No
*
10. How much would you pay for it at maximum?
Nothing, not interested
Rs.10
Rs.20
Rs.30
Other
Thank You for your time
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