JOHNSON J SURVEY

Name (optional): 


  1. What was the reason for your visit?
    Routine
    Follow-up
    Emergency
    Surgery


  1. Do you currently have insurance?
    Yes
    No


  1. If you do not have insurance, did a counselor advise you of ways to obtain medical insurance?
    No, I was not informed
    Yes, I was informed


  1. Does your medical insurance cover all costs of your visit?

    Yes
    I do not have medical insurance
    I have to pay partial cost for visit.


  1. Do you feel that your medical insurance caters to your every need?
    Yes
    No


  1. Is your insurance company provided?
    Yes
    No


  1. How many people are currently on your medical insurance plan?
    Single
    Two
    Three or more


  1. Are you satisfied with your current standing for medical care and insurance? If no, please provide feedback.
    Yes I am satisfied
    Yes I am satisfied but I wish to provide feedback.
    No I am not satified





Instructor and Lead Faculty for SOCI Online classes
Metropolitan Community College
Omaha, NE