Healthcare Survey Form

1. How would you rate your overall health?

2. How often do you exercise?

3.Have you ever been diagnosed with a chronic illness?

4. How do you prefer to receive medical information?

5. How satisfied are you with your current healthcare provider?

6. How often do you consume fruits and vegetables?

7. Have you ever experienced a medical error or misdiagnosis?

8. How do you prefer to pay for healthcare services?

9. How often do you visit your primary care physician?

10. Is There Anything Else That You Would Like To Share With Us That Could Help Us Improve Our Service?