INFORMED CONSENT 

Good day! We are third-year BS in Accountancy students of Ateneo de Davao University

currently doing our Project Feasibility Study about the Diagnostic Center.

This study aims to introduce our diagnostic center to our target customers and improve the

accessibility and availability of diagnostic testing services in Bago Oshiro, Davao City. The

questionnaire asks for basic information about the services, such as demographics, preferred

medical services, location, marketing, networking, and their actual access to medical facilities. It

will only take approximately 5 minutes to complete the survey questionnaire. 

The responses gathered will be kept confidential and private and will only be used for research

purposes. The researchers will strictly ensure that the Data Privacy Act of 2012 is followed.

Your participation in this study is entirely voluntary, and you are free to withdraw at any time.

We respect your privacy and your right to decline from participating in this study.
 Survey Questionnaire

Demographics

Name: ____________________________________________

Age: below 18; 18 y.o to 30 y.o; 31 y.o to 50 y.o; 51 y.o and above

Gender: Female; Male

Status: Student; Employed; Unemployed; Retired

Awareness

1. Do you know any diagnostic centers near your area?

● Yes

● No

2. If yes, what is the nearest diagnostic center near your area?

___________________________________________________

3. If yes, how many diagnostic centers do you know?

● 1

● 2

● 3

● 4

● More than 5

4. Have you been hospitalized as an in-patient or out-patient in the last 6 months? (in-

patient - admitted and spend at least one night in a hospital or other type of inpatient

facility; out-patient - admitted only in a hospital, walk-in-clinic, or in a doctor’s office)

● Yes

● No

5. Have you visited any laboratory/diagnostic facility in the last 6 months?

● Yes
 ● No

6. Have you done any medical consultations in the last 6 months?

● Yes

● No

7. What was the underlying reason for your previous diagnostic examination?

● Work Requirement

● Annual or Semi-Annual Physician’s Check-Up

● Doctor’s Referrals

● Medical Diagnosis

● Others:

8. Are you satisfied with the results of your past laboratory results?

● Yes

● No

9. Are you satisfied with the results of your past medical consultation or physical

examination?

● Yes

● No

10. Does the diagnostic center, independent or hospital-based and in terms of service,

exceed your expectations?

● Yes

● No

11. What kind of medical provider do you use for routine health care?

● Community health center

● Rural clinic

● Specialist

● Emergency/Hospital
 ● Others:

12. How far do you travel to the nearest medical facility?

● less than 1km

● 2 - 6 km

● 7 - 11 km

● 12 - 16 km

● More than 16 km

Crowdsourcing

13. If you are looking for a diagnostic center to avail their services, which would you prefer?

● Hospital Based

● Independent (such as vitalab, UM Multitest, etc)

● Feasibility, near where you are located.

14. If a diagnostic center will be established at your desired location, will you be willing to

avail services offered by the center?

● Yes

● No

15. What is your preferred location of the diagnostic center?

● Near hospital/clinic

● Near barangay

● Along the highway

● In the middle of the city

● Others:

16. Is our facility's location convenient for you?

● Yes

● No
 17. What services do you believe should be available at a diagnostic center, if one is

available near your area?

● Laboratory (Blood work)

● Speciality Physician

● Speciality Referrals

● X-ray

● Drug test

● ECG

● Fecalysis

● Urinalysis

● 2D Echo

● Ultrasound

● All of the above

18. Reasons for availing diagnostic services in the future

● Work requirement

● Annual check-up(?)

● Doctor’s referrals

● Medical diagnosis

● Others:

19. On a scale of 1-4 (4 being the highest), how important are the following to you in

considering diagnostic services

● Quality of service

● Price

● Accessibility of location

● Variety of services

PRICING
 1. How much are you willing to pay for the service of the Drug Test?

● 250 - 310

● 311 - 370

● 371 - 400

● more than P401

2. How much are you willing to pay for the service of Fecalysis?

● 70 - 75

● 76 - 80

● 81 - 85

● more than Php86

3. How much are you willing to pay for the service of ECG (with reading)?

● 350 - 399

● 400 - 449

● 450 - 499

● more than Php500

4. How much are you willing to pay for Chest X-Ray?

● 220- 250

● 250- 330

● 350-400

● more than 500

Hematology Tests (Blood-related) 1-10

1. How much are you willing to pay for Free Thyroxine (FT4)?

● 450 - 500

● 500 - 550

● 550 - 600

● More than 600

2. How much are you willing to pay for Free Triiodothyronine (FT3)?

● 450 - 500

● 500 - 550

● 550 - 600

● More than 600

3. How much are you willing to pay for Thyroid Stimulating Hormone (TSH)?

● 500 - 550

● 550 - 600

● 600 - 650

● More than 650

4. How much are you willing to pay for Serum Glutamic Pyruvic Transaminase (SGPT)?

● 200 - 250

● 250 - 300

● 300 - 350

● More than 350

5. How much are you willing to pay for Complete Blood Count (CBC)?

● 175 - 225

● 225 - 275

● 275 - 325

● More than 325

6. How much are you willing to pay for High-Density Lipoprotein (HDL)?

● 200 - 250

● 250 - 300

● 300 - 350

● More than 350

7. How much are you willing to pay for Low-Density Lipoprotein (LDL)?
 ● 200 - 250

● 250 - 300

● 300 - 350

● More than 350

8. How much are you willing to pay for Blood Urea Nitrogen (BUN)?

● 150 - 200

● 200 - 250

● 250 - 300

● More than 300

9. How much are you willing to pay for Uric Acid (BUA)?

● 120 - 170

● 170 - 220

● 220 - 270

● More than 270

10. How much are you willing to pay for Fast Blood Sugar (FBS)?

● 120 - 170

● 170 - 220

● 220 - 270

● More than 270

11. How much are you willing to pay for Urinalysis?

● 330 - 370

● 370 - 420

● 420 - 500

● More than 500

12. How much are you willing to pay for 2D Echo?

● 2,500 - 3000
 ● 3,000 - 3,500

● 3,500 - 4,000

● More than 4,000

13. How much are you willing to pay for Ultrasound (whole abdomen)?

● 1,300 - 1,800

● 1,800 - 2,300

● 2,300 - 2,800

● More than 2,800

MARKETING

1. How did you find out about the diagnostic centers available in your area?

● Social Media

● Radio/Television

● Doctor’s referral

● Word of mouth

● Others:

2. How would you prefer to receive information about the services offered by the center?

Social Media

Radio/Television

Doctor’s referral

Word of mouth

Others:

3. What is your preference in receiving laboratory results?

● Pick-up

● Online (Email)

● Others:________

4. How do you want to book appointments?

● Online

● Text

● On-site

● Others_____