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Hello:
You are invited to participate in our survey [Young Adult's Perception of Affordable Care Act]. In this survey, approximately [100] people will be asked to complete a survey that asks questions about [Health Insurance ]. It will take approximately [5] 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 [Devika Sharma] 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.

Sincerely
Devika Sharma
[email protected]
 
 
 
How old are you
 
18-23
 
24-29
 
30-35
 
 
 
Are you: 
 
Male
 
Female
 
 
 
Do you currently have a health insurance?
 
Yes
 
No
 
 
 
What kind of health insurance do you have?
 
Employer based
 
Military
 
On Parents health insurance
 
Medicaid
 
 
 
If you do not have health insurance, did you sign up for "Obamacare" before the Feburay 15th, 2015 deadline?
 
Yes
 
No
 
 
 
Will you purchase health insurance under the Affordable Care Act , or would you choose to pay  a penalty for not having health insurance?
 
Purchase
 
Penalty
 
 
 
Do you think everyone should be mandated to have health insurance?
 
Yes
 
No
 
 
 
Do you think Obamacare/Affordable Care Act is a step in the right direction to provide health insurance to all Americans?
 
Yes
 
No
 
 
 
How important is health insurance  in the United States?
 
Very important
 
Important
 
Somewhat Important
 
Don't know
 
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