Sample Survey | QuestionPro

Hello:

You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] 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 stricly 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 [Name of Survey Researcher] at [Phone Number] or 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.

Somewhat dissatisfied

Age of person completing this questionnaire:

The following set of questions deals with medical examination services. These services perform routine examinations like the kind that are used to qualify for life insurance.

	Not At All Important	Somewhat Unimportant	Neutral	Somewhat Important	Very Important	Not applicable/ Not sure
Speed in completing examination and reports

Accuracy and completeness in filling out your report

Expertise of medical staff

Medical representative treatment of your client

Offers all services required for examination

Wide geographic area of service coverage

Hand delivery of reports to insurance office

Personal relationship with a representative of the agency