Web Survey about Insurance: These are questions from a web survey that focus in Insurance issues. It is intended for doctors to answer. It is a physician Web survey regarding the impact of insurance determinations on physicians course of treatment. Members can create an Web survey based on a web survey template like this insurance survey template by joining SurveyShare, the custom web survey tool! We have put this free internet survey resource online so that you can see examples of good survey questions that you can use in your own survey. If you decide not to join SurveyShare, we wish you luck with your project, and hope that you find value in our example web surveys.         1) Does your office bill patient insurance? -- Select Here -- Yes No 2) Does your office participate in HMO or preferred provider programs? -- Select Here -- Yes No 3) Do you discuss insurance coverage for specific services with your patients prior to providing treatment? -- Select Here -- Yes No 4) How much do insurance company coverage determinations affect your decision-making in patient care? Great Deal Somewhat Very Little Not at All 5) 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 6) How often do you determine what the patient's insurance will cover prior to planning the course of treatment? Often Sometimes Rarely Never 7) How much do you feel insurance providers' determinations infringe upon your decision-making for patient treatment? Great Deal Somewhat Very Little Not at All 8) How much do you think insurance providers' determinations have affected how your patients approach their medical care? Great Deal Somewhat Very Little Not at All 9) What is your profession? General Practice Physician Medical Specialty Physician Physician's Assistant Nurse Practitioner RN LPN General Dentistry Dental Specialty Other: 10) Are you male or female? -- Select Here -- Male Female 11) What is your age? -- Select Here -- 20-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 Over 65 12) How long have you been in practice? -- Select Here -- Less than 1 year 1-3 years 4-6 years 7-9 years 10-12 years 13-15 years 16-19 years 20 or more years 13) Do you work in private practice, clinic or medical group, or a hospital? Private Practice Clinic or Medical Group Hospital Other:

Web Survey Template Questions Web Survey about Hospital Services Search for Free Assessment Survey template (uses Google) Search the Web for Emergency Room Visit Survey Online Survey Tool * Free Online Surveys * Free Customer Satisfaction Survey Sites