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First Responder and Healthcare Professional Benefits Questionnaire
This questionnaire will explore the topic of employment benefits. Do you use them? Are they enough? Do they effect your career? Lets find out.
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* Indicates required question
What is your current occupation?
*
Paramedic/EMT
Firefighter
Police Officer
Nurse
Dispatcher
Other:
How long have you worked in this profession?
*
Under 3 years
3-5 years
6-10 years
11-15
16-20
21-25
Above 25
How old are you?
*
20-24
25-34
35-44
45-54
55-64
65+
How do you identify
*
Male
Female
Prefer not to say
Other:
What country and province/state do you currently work in?
Your answer
Do you use your benefits?
*
Yes
No
Some of them
Do you have family covered under your benefits
*
Yes
No
Do you think that having benefits affects the longevity of your career?
*
Yes
No
Please specify the benefits provided by your employer. If other, list all.
*
Dental
Vision
Mental Health Services
Health Insurance
Retirement/Pension Plan
Flexible Spending Account
Other:
Required
Please indicate your level of satisfaction with the range of benefits included in your plan.
*
Not satisfied
1
2
3
4
5
6
7
8
9
10
Very satisfied
Please indicate your level of satisfaction with the extent of coverage provided for each benefit.
*
Not satisfied
1
2
3
4
5
6
7
8
9
10
Very satisfied
Please list the benefits that are most important to you.
*
Your answer
Are there any additional benefits that you do not currently have, but would like to be offered? Please list them.
*
Your answer
Are there any benefits that you currently have that you feel are insufficient for your needs? If so, list which ones.
*
Your answer
How important are benefits to you?
*
Not important
1
2
3
4
5
6
7
8
9
10
Very important
Please add any additional comments you may have in regards to this survey.
Your answer
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