Get Insurance Survey Form Sample

This guide provides clear and supportive instructions on how to complete the Insurance Survey Form Sample online. Following these steps will help ensure that your responses are submitted accurately and efficiently.

Follow the steps to complete the Insurance Survey Form Sample online

1. Click ‘Get Form’ button to access the form and open it for editing.
2. Fill in the date and time of the interview at the top of the form. Ensure the information reflects the current date and time.
3. Complete the section for the Sub District, Area Council, Community, House ID, and House Name accurately to provide clear identifiers for the respondent's location.
4. Enter the name of the interviewer in the designated field to ensure accountability.
5. In the background information section, fill in the age of the respondent in completed years and select the status, sex, and marital status from the provided options.
6. Record the highest educational level achieved by the respondent by selecting the appropriate option and include the number of completed schooling years.
7. Ask the respondent if they can read and write in local languages, recording their responses as yes or no. Specify which languages they can read or write.
8. Document how many people are in the respondent's household, ensuring clarity on the definition of household as shared economic producers.
9. In the demographic and socio-economic section, select the nearest health insurance participating clinic and how the respondent travels there.
10. Gather information about the respondent’s experiences with the health insurance scheme, including how they learned about it and their reasons for renewing membership.
11. Record responses regarding the usage of health facilities, reception quality, and any payments made for services.
12. Conclude by asking for general comments or suggestions about the health insurance scheme's improvement.
13. Once all relevant fields are filled, users can save changes, download, print, or share the completed form according to personal needs.

Complete the Insurance Survey Form Sample online to contribute to valuable community health insights.