Let's Build NEW Affordable Health Plan We Can All Use.

EVOKE Foundation is a Non Profit organization dedicated to social change through Art & Media. In these challenging times we began to realize that we, the creatives, need our own support. One change we all need right now is affordable health insurance. With the power of numbers we can build a group plan and share the cost, we are in this together. The more we grow our collective buying power increases and reduces the cost of your plan.
 
This Information will help us develop a group health plan that will be very affordable for everyone in our industry that can not normally be obtained without large buying power.
NONE of this information will be shared in any way outside of our small team at EVOKE.

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* 1. Occupation 

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* 2. Age

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* 3. Employment status

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* 4. Do you belong to an Association / Professional Group or club ? Please name it.

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* 5. Does it worry you to not have health insurance ?

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* 6. Do you currently have health insurance ?

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* 7. If you are not insured what is the reason ?

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* 8. What is the most important health coverage for you ?

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* 9. What is important to you about health insurance ?

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* 10. What worries you the most about health insurance ?

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* 11. What is the most you can afford to pay for health insurance per month for individual ?

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* 12. What is the most you can afford to pay for health insurance for your family ?

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* 13. Would you pay a membership fee of $10.00 per month to join an association with other benefits get access to considerably reduced insurance premiums ?

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* 14. Would you like to tell us what you'd like to see in a health plan ?

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* 15. Would you like to be notified when EVOKE Insurance becomes available ?

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* 16. Your details - Only for the purpose of this survey. It's important but we made this optional for you. By not filling this out we have no way to contact you again.

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* 17. Would you like to refer a friend or colleague ?
The more we grow our collective buying power increases and reduces the cost of your plan. We are in this together.

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