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Health Insurance Coverage Survey Template

Health Insurance Coverage Survey Template offers questions and examples on the quality of a respondent's current healthcare provider. This sample can be edited by the survey maker according to the required details about the health insurance coverage. Some of the question examples of this questionnaire are demographical such as "What is your age?", "What is your family's annual income?" or "What is your marital status?" et al.


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1. What is your gender?
4. What is the highest level of education you have attained?
5. What is your marital status?
6. Are you disabled?
7. Please mark your annual gross income?
8. Which of the following group of race best describes you?
9. Which health coverage are you currently enrolled with?
10. How difficult is it for you to pay health insurance cost?
11. Do you have a child 26 years and below that you have been unable to include in your coverage?
12. Has any of your family members been dropped out of coverage after a diagnosis of some illness?
13. Has lack of health insurance cover made you consider one of the following?

ヘルスケア調査

医療検査サービス調査テンプレート

21 質問

診察の機能、および現在のサービスの顧客の態度の望ましさのための医療サービス評価調査。

ヘルスケア調査

ヘルスケア意識調査テンプレート

44 質問

品質、手頃な価格、可用性、および顧客の嗜好に関する病院やヘルスケア世論調査。

ヘルスケア調査

医師・プラクティス調査テンプレート

47 質問

医師は、提供病院やサービスの評価を提供し、調査を実践します。