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* 1. Booking ID (please fill in the 4 digit code provided by your trainer)

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* 2. Your Gender:

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* 3. Your Race :

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* 4. Your Citizenship:

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* 5. Your Age Range:

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* 6. Your Current Family Status:

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* 7. Your Highest Level of Education:

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* 8. Your Annual Household Income Range (Before Taxes):

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* 9. Please respond by CLICKING the appropriate number on the scale from (Strongly Disagree) to (Strongly Agree).

  Strongly Disagree Disagree Neutral Agree Strongly Agree
The training session has achieved its objectives.
The materials are useful to me.
There was appropriate use of examples and exercises to help me understand the topic.
The concepts and skills presented help me in my personal development.
The trainer has good knowledge of the topic.
The trainer is able to communicate the ideas and concepts to me.
The trainer makes the topic relevant to me.
The trainer uses practical examples.

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* 10. What did you find MOST useful to you about this talk?

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* 11. What did you find LEAST useful to you about this talk?

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* 12. How can we improve on this talk?

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* 13. What other financial topics are you keen to know more about? (TICK whichever applies to you)

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* 14. Would you like to receive our (Institute for Financial Literacy) E-Newsletters?

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* 15. Please CLICK your response to each of the following statements.

  Do Not Know True False
Claim limits refer to the portion of the medical bill that you can claim from your insurer.
The coordination of benefits means that I can claim more than 100% of my actual medical expenses from the combination of my health insurance policies.
A deductible is the fixed amount I need to pay for claim(s) made in a policy year, before the insurance coverage applies.
Most health insurance policies do not impose a waiting period.
Disability Income is a health insurance product that gives me a fixed payout for each day I am hospitalised for treatment.

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* 16. How confident are you to do each of the following?

  Not Confident A Little Confident Confident Very Confident
Calculate the amount of health insurance I should have.
Identify the different types of health insurance products.
Assess my health insurance needs.
Differentiate between long term care and disability income.
Select suitable health insurance products for myself and my dependants.

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* 17. AFTER attending this talk, what is your intention to do each of the following?

  Does Not Apply To Me No Maybe Yes I Am Already Doing This
Calculate the amount of health insurance I should have.
Identify the different types of health insurance products.
Assess my health insurance needs.
Differentiate between long term care and disability income.
Select suitable health insurance products for myself and my dependants.

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