Customer Survey Form - Driefcase

Help Us Serve You Better

DRiefcase wants to partner with you and support you in your health journey. Your participation in this quick survey will help us to better understand your preferences and needs, allowing us to tailor our content and offerings more effectively.

What is your marital status?

I’m Single I’m Married I’m Divorced Other

When is your marriage anniversary?

Do you have kids?

Yes No

Do you currently have corporate or personal health insurance?

I have a corporate health insurance plan I’m self employed and pay for my health insurance No, I don’t have health insurance

Would you be interested in knowing better how to evaluate life and health insurance products?

Yes No

How do you typically seek information about any health conditions?

Online research Doctor consultation Advice from family or friends Other (please specify)

Specify how you seek information about any health conditions?

Would you like to know about various health conditions/diseases and their treatments?

None Balanitis Banaloposthithis Cataract ENT Fissure Fistula Gallstones Hernia Kidney Stone Lipoma Phimosis Piles Pilondial Sinus Varicose Veins Others

Did you find the executive's behavior and conduct to be professional?

Yes No

Did the executive help you with filling out this survey?

Yes No

How would you rate the overall assistance provided by the executive?

Poor Fair Good Excellent

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