Please fill out this survey for a research
0 - 17
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or more
Less than HS diploma
Please select your Income per year
$0 - $24,999
$25,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 - $149,999
$150,000 or more
How important do you consider health insurance to be?
Do you currently have health insurance coverage?
Who pays for your health insurance?
Which of these is covered in your health insurance plan?
Pregnancy and Childbirth
Mental Health Services
Emergency Room Visits
Inpatient and Outpatient Care
How much is your monthly premium?
How easily can you access the network hospitals included in your coverage?
With your current coverage, how easy is it to file a claim?
If you do not have a health insurance coverage, why are you not insured?
I don’t need insurance
I can’t afford insurance
Employer does not offer insurance cover payments
Dissatisfied with previous coverage
I do not believe in health insurance
Which form of rewards do you prefer?
Amazon Gift card
Finally your Email (or Paypal email if you chose that way)
Should be Empty:
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