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QUESTIONNAIRE: HEALTH & WELLNESS PLATFORM

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:

Less than 25years

3. YOUR GENDER :
4.

25-35years

Male

MARITAL STATUS:

35-50years

Above 50years

Female

Married

Single

5. IMMEDIATE FAMILY SIZE: ________________________


6. PROFESSION:
Housewife

Service personnel

Self employed

Student

Retired

Other

7. If possible can I have your EMAIL ID: _____________________


PART B:

1. Please help us understand your health needs better


SERVICES

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

2. Please help us understand your wellness and lifestyle needs better


SERVICES

Fitness Regime

Health
Supplements/
Products

Spa & Saloon

Are you a member of any


service provider?
Frequency of visit Half
Yearly
Approx. spend per visit
Preferred Service
provider? Why and since
how long?

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

a) Price & Discounts


b) Brand/ Awareness
- Range of services
- Infrastructure
- Cleanliness/ Hygiene
c) Service Standard
- Response Time
- Customer Service
d) Convenience
- VAS
- Loyalty Programme

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

Please specify _________________________

6. Are you covered under any Health Insurance?


Yes

No

a) If yes, then which one?


_____________________________________________________________________

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

Direct Mail and Plastic Card

8. How often do you use the following?


Parameters
Mobile Apps
Online Retail/ Purchase
(a) Which sites

Not at all

Rarely when needed

Frequently

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