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Hello:
You are invited to participate in our survey Factors affecting choice of Health Insurance. In this survey, approximately 100 people will be asked to complete a survey that asks questions about Health Insurance coverage. It will take approximately 10 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Tim Toledo by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
1. Indicate your gender
 
Male
 
Female
 
 
 
Indicate your age group
 
18-25
 
26-38
 
39-50
 
51-65
 
66 and above
 
 
 
Describe your ethnicity
 
Caucasian-American
 
African American
 
Hispanic American
 
Asian-Pacific Islander
 
Other
 
 
 
 
Educational Background
 
High School Diploma
 
College undergraduate
 
College graduate
 
Post Graduate
 
Other
 
 
 
 
Employment Status
 
Employed Full time
 
Employed Part time
 
Contractual
 
Retired
 
Other
 
 
 
 
Marital Status (check whatever applies)
 
Single
 
Married
 
With dependents

 
 
 
Living arrangements
 
Own a house
 
Renting
 
Sharing a room
 
Living with parents
 
 
 
Do you subscribe to any any health insurance?
 
Yes
 
No
 
 
 
Are you a dependent of a subscriber to an insurance?
 
Yes
 
No