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Health Insurance Questionnaire Template

This health insurance questionnaire template is for insurance companies to collect information about an applicant’s health history and current health status. This information can be used to assess the applicant’s risk profile and determine their eligibility for coverage, as well as the premium amount they will pay.

This sample questionnaire has a conversational UI and white labeling features that enhance the questionnaire-filling experience of the respondent.

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Why use this Health Insurance Questionnaire Template?

Offer best fit insurance plans, boost client satisfaction with this health insurance questionnaire


Benefits of Health Insurance Questionnaire Template


Easy Photo Submissions

Applicants have the convenience of taking and submitting photos directly within the questionnaire using their selfie camera. This makes it easier to provide any required visual information.

Versatile Question Formats

To gather detailed information, the questionnaire supports various types of questions. This includes rank-based questions, heat maps, open-ended questions with voice transcription, and more, ensuring a thorough collection of applicant data.

Smart Question Navigation

The questionnaire uses skip/display logic to present relevant questions based on previous answers. This feature can also recommend the most suitable plan and provide personalized thank-you pages at the end, making the process efficient and tailored to each applicant.

Simple Document Uploads

Applicants can easily upload necessary documents through the questionnaire. These documents are accessible in the dashboard, assisting in the selection of the appropriate health plan.

Offline Accessibility

The questionnaire can be completed without an internet connection. By installing the SurveySparrow app on a tablet or kiosk, information can be collected conveniently at any time and place, ensuring no applicant is left out.


5 Must Ask Questions before suggesting a Health Insurance Plan


What are your current health needs and concerns?

This helps understand if they have any pre-existing conditions or require specific coverage (e.g., maternity care, mental health services).


What is your budget for health insurance?

Knowing their budget allows you to suggest plans with appropriate premiums and deductibles. Explore options that fit their financial situation to avoid overspending.


Do you have a preferred doctor or hospital network?

Many plans have limitations on in-network and out-of-network coverage. Understanding their preference helps recommend plans with access to their desired providers.


Do you typically use preventive care services (e.g., annual checkups, vaccinations)?

Knowing their preventive care habits helps suggest plans that offer strong coverage for these services, potentially saving them money in the long run.


Do you anticipate any major life changes (e.g., starting a family, retirement) in the near future?

Life changes might impact their healthcare needs. For example, someone planning to start a family might need a plan with strong maternity coverage.


Who Can Use This Health Insurance Questionnaire Template?


Health Insurance Companies

Tailored for insurers to streamline applicant screening, collect comprehensive health data, and assist in offering the most suitable insurance plans based on personalized health profiles.

Healthcare Providers

Hospitals and clinics can use the template to understand patient demographics, health history, and insurance needs, enhancing patient care and insurance coverage recommendations.

Corporate HR Departments

Ideal for human resources to gather employee health insurance requirements, understand coverage preferences, and facilitate the selection of employee benefits packages that align with their health and wellness goals.

Government Health Agencies

Useful for collecting data on public health insurance needs, assessing community health trends, and tailoring public health insurance programs to better meet the population’s needs.

Research Institutions

Researchers can utilize the template to conduct studies on health insurance trends, effectiveness of coverage, and to understand the factors influencing insurance choices among different demographics.

Insurance Brokers and Agents

Enables brokers to efficiently collect client information, assess client needs for health insurance, and recommend plans that match their health profile and budget constraints.


How to use this template?


Step 1: Customize Your Questionnaire

Start by personalizing the questionnaire to fit your brand. You can edit background colors, fonts, and even add a video background to the welcome and thank-you pages. Tailor your questionnaire by adding or removing questions to capture the information you need. For more precise adjustments, utilize SurveySparrow’s AI wing feature to rephrase questions for right tone or dive into CSS for advanced customization.

Step 2: Integrate with Third-Party Apps

Enhance your questionnaire’s usability by integrating it with popular third-party applications like HubSpot, Zapier, Mailchimp, and Google Sheets. These integrations streamline your workflow, allowing you to automate data collection and management processes seamlessly.

Step 3: Share Your Questionnaire

Distribute your health insurance questionnaire through multiple channels to reach your audience effectively. SurveySparrow offers various sharing options, including direct links, SMS, email campaigns, social media, webpage embeds, and QR codes. This variety ensures you can connect with respondents wherever they are.

Step 4: Check Responses in the Dashboard

Monitor and analyze the responses to your questionnaire using the intuitive SurveySparrow dashboard. Here, you can export data to CSV for further analysis or use built-in filters and widgets to sift through responses. The dashboard gives you a comprehensive overview of your data, helping you make informed decisions based on the insights gathered.



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