Insurance Survey example

This is an example Insurance Survey survey. This survey includes questions like:

We hope this will help you create your own Insurance Survey survey. We have not tested the validitiy or reliability of this survey. However, you may use this as a starting point to help your own survey instrument. Feel free to change and edit any of our survey templates to help you get started.

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1) How much do insurance requirements or coverage affect your decision-making in patient care?
  • Great Deal
  • Somewhat
  • Very Little
  • Not at All
2) How often have you personally dealt directly with an insurance company to get specific treatments or services covered for a patient?
  • Often
  • Sometimes
  • Rarely
  • Never
3) How often do you determine what the patient's insurance will cover prior to planning the course of treatment?
  • Often
  • Sometimes
  • Rarely
  • Never
4) How much do you feel insurance provider's determinations infringe upon your decision-making for patient treatment?
  • Great Deal
  • Somewhat
  • Very Little
  • Not at All
5) How much do you think insurance provider's determinations have affected how your patients approach their medical care?
  • Great Deal
  • Somewhat
  • Very Little
  • Not at All
6) What is your profession?
  • General Practice Physician
  • Medical Specialty Physician
  • Physician's Assistant
  • Nurse
  • Nurse Paractitioner
  • General Dentistry
  • Dental Specialty
  • Other:
7) Are you male or female?
8) What is your age?
9) How long have you been in practice?
10) Do you work in private practice, clinic or medical group, or a hospital?
  • Private Practice
  • Clinic or Medical Group
  • Hospital
  • Other:
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