Professional Documents
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Survey-Questionnaire
Survey-Questionnaire
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
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
Awareness
● Yes
● No
___________________________________________________
● 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
● Yes
● No
● Yes
● No
● Yes
● No
7. What was the underlying reason for your previous diagnostic examination?
● Work Requirement
● 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,
● Yes
● No
11. What kind of medical provider do you use for routine health care?
● Rural clinic
● Specialist
● Emergency/Hospital
● Others:
● 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
14. If a diagnostic center will be established at your desired location, will you be willing to
● Yes
● No
● Near hospital/clinic
● Near barangay
● Others:
● No
17. What services do you believe should be available at a diagnostic center, if one is
● Speciality Physician
● Speciality Referrals
● X-ray
● Drug test
● ECG
● Fecalysis
● Urinalysis
● 2D Echo
● Ultrasound
● 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
● 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
2. How much are you willing to pay for the service of Fecalysis?
● 70 - 75
● 76 - 80
● 81 - 85
3. How much are you willing to pay for the service of ECG (with reading)?
● 350 - 399
● 400 - 449
● 450 - 499
● 220- 250
● 250- 330
● 350-400
1. How much are you willing to pay for Free Thyroxine (FT4)?
● 450 - 500
● 500 - 550
● 550 - 600
● 450 - 500
● 500 - 550
● 550 - 600
3. How much are you willing to pay for Thyroid Stimulating Hormone (TSH)?
● 500 - 550
● 550 - 600
● 600 - 650
4. How much are you willing to pay for Serum Glutamic Pyruvic Transaminase (SGPT)?
● 200 - 250
● 250 - 300
● 300 - 350
5. How much are you willing to pay for Complete Blood Count (CBC)?
● 175 - 225
● 225 - 275
● 275 - 325
6. How much are you willing to pay for High-Density Lipoprotein (HDL)?
● 200 - 250
● 250 - 300
● 300 - 350
7. How much are you willing to pay for Low-Density Lipoprotein (LDL)?
● 200 - 250
● 250 - 300
● 300 - 350
8. How much are you willing to pay for Blood Urea Nitrogen (BUN)?
● 150 - 200
● 200 - 250
● 250 - 300
9. How much are you willing to pay for Uric Acid (BUA)?
● 120 - 170
● 170 - 220
● 220 - 270
10. How much are you willing to pay for Fast Blood Sugar (FBS)?
● 120 - 170
● 170 - 220
● 220 - 270
● 330 - 370
● 370 - 420
● 420 - 500
● 2,500 - 3000
● 3,000 - 3,500
● 3,500 - 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
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:
● Pick-up
● Online (Email)
● Others:________
● Text
● On-site
● Others_____