Health Insurance Survey Template

NOTE: If the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) applies to you and your intended use of SurveyMonkey, this template is NOT intended for your use without 1) a SurveyMonkey ‘HIPAA-enabled’ account, and 2) a business associate agreement with us, which can be purchased by contacting our sales team. Please see our Acceptable Uses Policy for more information.

Whether you work in social services or in the medical industry, knowing whether people have health insurance—and if so, what kind—is crucial information that can help you identify gaps in care and quality of health. Our expert-certified “Do you have health insurance?” template gives you insights into the status of their health coverage—from who insures them, to why they don’t have insurance.

Learn not only if people have health insurance, but who pays for the insurance if people have it, and what the insurance covers. This “Do you have health insurance?” survey will help you understand the full picture behind people’s insurance status so that you can address any unmet insurance and care needs. Customize the form if there are certain questions you’d like to ask.

To create a survey using the Do You Have Health Insurance? survey template, just sign up or sign in to SurveyMonkey. You’ll be able to choose the template when you begin creating a survey.

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