1.

Please mention your age bracket

a) <40 years b) 40-55 years c) 55-65 years d) >65 years

2. You live in a nuclear family/joint family (Please tick)

3. How often do you seek help from your neighbours?

a) Never b) Sometimes c) Often d) Very Often e) Any time as they are like our extended family

4. Do you have a permanent maid? Y/N

5. Are you or your family members covered by any medical insurance? Y/N

6. Are you or any member of your family affected by any chronic disease?

Please Mention the disease and age of the person affected____________________________

7. Have you ever availed home healthcare related services for yourself or any member of your family? Y/N

8. If yes, what type of service?

Please mention____________________________________________________________________

9. If a one stop In-home healthcare service facility is made available in Jamshedpur, which of the following services you
might avail for yourself/your family members if need comes?

a) Eldercare services for your ageing parents

b) Nursing services for post-surgical care/urinary catheterisation care/ wound care/Frequent Injections and IV
Infusions/ vaccinations at home/oxygen administration
c) Personalised physiotherapy treatment at home
d) In-home doctor service for general check-up/orthocare/post-hospitalisation cardiac care/diabetic care
e) Mother-care/baby care for your wife and new-born baby/ In-pregnancy services for your wife
f) In-home lab services
g) Pharmacy delivery at your doorstep
h) In-home trained attendant service
i) Any Other. Please Mention__________________________________________________________________

10. How would be willing to pay for the above mentioned services?
a) Hourly basis for Nursing/Attendant service (Please mention range________)
b) Per visit basis for In-home doctor consultations (Please mention range________)
c) Subscription basis(Quarterly/half-yearly/annual) (Please mention range________)

11. If you would be looking for a homecare service provider what would be the important criteria to choose such a company?
Please rate all the criteria on a scale 1-5; 1-least important, 5-Most Important)
a) Cost (Rate (1-5) ___)
b) 24x7 assistance and multiple customer touchpoints (Rate (1-5) ___)
c) Help in obtaining financial aid for availing the services (Rate (1-5) ___)
d) Reviews from people who have previously used the service from the provider (Rate (1-5) ___)
e) Rules and criteria for hiring staff (Rate (1-5) ___)

12. When choosing a homecare assistant (Like Nurse/In-home trained attendant) what information would you like to know
about the person?
a) Gender
b) Age
 c) Background check
d) Extra skills and interest
e) Valid ID card and address proof
f) You would want to interview the person/keep on trial period before hiring
g) Others __________________

13. Which of the following sources you consider as the most credible while choosing your health care service provider?
a) Newspaper Advertisements
b) Internet
c) Billboards
d) Recommendations by an organisation (company or charity)
e) Radio
f) Television
g) Customer Reviews on company website/blogs

14. If a home-care service is made available in your city by an agency/hospital, would you avail it if it fits in your budget?
Y/N