quick 2 minute survey

<p>As part of one of my classes, I need to survey a range of people on the health care system. If you could please fill out this short survey just as a reply I would really appeciate it.</p>

<p>SURVEY</p>

<p>Age: 14-20 21-35 36-55 over 55</p>

<p>Gender: ____________</p>

<p>Religion: ____________</p>

<p>Ethnicity: ____________</p>

<p>Are you satisfied with the current health care system?</p>

<p>YES NO</p>

<p>Do the following variables affect your opinion on health care reform?</p>

<p>Personal Financial Burden: YES NO</p>

<p>Political Party Affiliation: YES NO</p>

<p>Parental Opinion: YES NO</p>

<p>Satisfaction with Current
Medical Insurance Plan: YES NO</p>

<p>Family Medical Problems: YES NO</p>

<p>Morals/Religion YES NO</p>

<p>Rate the following variables in order of their importance to your opinion
(1-10, one being the most important):</p>

<p>Financial Burden</p>

<hr>

<p>Political Party Affiliation</p>

<hr>

<p>Parental Opinion</p>

<hr>

<p>Satisfaction with Current
Medical Insurance Plan</p>

<hr>

<p>Family Medical Problems</p>

<hr>

<p>Morals/Religion</p>

<hr>

<p>Do you believe in universal healthcare for everyone? That is, should the government provide universal healthcare?</p>

<p>YES NO</p>

<p>IF NO: Do you believe in providing healthcare for children ages 0 to 18?</p>

<p>YES NO</p>