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Respected Sir/Maam,
I request you to kindly take out 10-15 minutes as a survey is being conducted to help us gauge
the Health and Wellness industry in Delhi/ NCR Region. All information provided by you here
will be kept confidential and will be used to understand your expectations and perceptions better.
Thank you!
PART A:
PERSONAL INFORMATION
1. NAME :
2.
AGE:
3. YOUR GENDER :
4.
25-35years
Male
MARITAL STATUS:
35-50years
Above 50years
Female
Married
Single
Service personnel
Self employed
Student
Retired
Other
Reason Of Visit
Frequency of visit Half
Yearly
Approx. spend per visit
Preferred Service
provider? Why and
since how long?
Privileged Membership
Hospitals
Labs/
Diagnostic
centre
Annual Health
Annual Health
Check/
Check/
Preventive Care
Preventive Care
Any Ailment
Any Ailment
Consultation
Other clinics
(Dentist, eye
care)
Annual Health
Check/
Preventive Care
Any Ailment
Consultation
Pharmacy
Preventive
Specific Ailment
Basic
Other products
Fitness Regime
Health
Supplements/
Products
3. Rate the following as per your importance while choosing a service provider in the
Health & Wellness arena:
RATING SCALE
PARAMETERS
Not
Important
Important
Very Important
4. Who takes the decision in your home for Health & Wellness needs?
You
Spouse
Joint
Parents
5. Are you currently using any health/wellness package/offers/program that gives you
benefits on usage? (either individual or through corporate)
Yes
No
Personal
Corporate
No
7. Would you be interested in a package that offers benefits on key Health & Wellness
services on one platform?
Yes
No
a) For such a holistic Health & Wellness platform, how much would you be willing to pay
for an annual membership?
Rs.1500 - 2500
Rs.2500 - 3500
Rs.3500-Rs.4500
Rs.4500-5500
b) If yes, please rate the following benefits on a scale of 1-5 (5 being most important and 1
least important) according to your preference?
Special services/pricing at hospitals/ clinics
Discount at labs & Diagnostic centers
Discount at pharmacy
Discount at fitness centers
Discount on health equipments & products
Spa / wellness vouchers
Others.. Please Specify _________________
c) For using such a service as described earlier, what would be your preferred mode of
usage?
Internet/Online communication and Mobile Apps
Not at all
Frequently