Morgan Davenport- M9 Survey
Name (optional): 


  1. What is your current employment status?
    Full time employment
    Part time employment
    Student
    Retired
    Other


  1. Who provides your health insurance?
    Parents
    Self
    Employer
    Spouse
    No insurance


  1. If you are employed, does your employer provide insurance for all employees?
    Yes
    No


  1. Who is your primary care physician?


  1. Do you have healthcare insurance?
    Yes
    No


  1. How many times a year do you visit the doctors office?
    Only for physicals
    2+
    6+
    10+
    NEVER!


  1. Do you believe that your insurance limits how many times you go to the doctor?
    Yes
    No


  1. How satisfied are you with your current health insurance?
      1 2 3 4 5  
    Excellent   Poor


  1. How long have you been with your current health insurance?
    0 to 5 years
    5 to 10 years
    10 to 15 years
    20+ years


  1. Is everyone in your household covered under your insurance?
    Yes
    No





Mrs. Fauchier