Fundraising Card Program

This is the questionnaire that deals with a new Fundraising Card Program. This Card provides the patients free of charge services and discounts after collecting points when using it in previous Saint George Hospital services. Please take a few minutes to express your opinions about the interest and quality of this product. Your information will be coded and will remain confidential. Your answers are important to the success of this study.

Thank you for your assistance.

1) Your Age:

2) Gender:

Male

Female

3) Below are a list of features that are part of the product. How important is each feature to you?

4) Select the rating that best describe how you feel about this product.

5) Based on the VIP Card, how interested would you be in buying this new [Product] if it were within your budget? Please check one:

6) After reading the above product description, how interested would you be in using the described product?

Not at all interested

Not very interested

Neither interested nor uninterested

Somewhat interested

Extremely interested

7) Have you ever tried a similar product?

Yes

No

8) How often do you use products from this [Product Category]?

Are you satisfied with the product you are using currently?

Yes

No