모든 템플릿

Health Data Sharing Trust & Privacy Preferences Survey

Measures patient comfort, consent preferences, and privacy concerns when sharing health data across providers, insurers, and digital health tools. Ideal for healthcare organizations, privacy teams, and compliance officers seeking to understand patient attitudes toward data sharing.

샘플 질문

템플릿에 포함된 내용을 미리 확인해 보세요. 모든 질문은 설문 공개 전에 자유롭게 수정할 수 있습니다.

질문 21개 · 약 10분
Q01
메시지

Welcome to this research survey on health data sharing preferences. This survey takes approximately 10 minutes to complete. Your participation is entirely voluntary, and you may stop at any time. There are no right or wrong answers — we are simply interested in your honest opinions. All responses are confidential, will be anonymized, and reported only in aggregate for internal research purposes. By continuing, you acknowledge that you have read and understood this information.

Q02
객관식

In the last 12 months, have you visited any health professional (e.g., doctor, nurse, therapist)?

  • Yes
  • No
Q03
객관식

In the last 12 months, which of the following health or wellness tools have you used? Select all that apply.

  • Fitness/activity tracker (e.g., Fitbit, Apple Watch)
  • Nutrition or calorie app
  • Symptom checker or health chatbot
  • Medication reminder app
  • Telemedicine/virtual care platform
  • Patient portal (e.g., MyChart)
  • Sleep tracking app/device
  • Mental health app
  • Other (please specify)
  • None of the above
Q04
의견 척도

How comfortable or uncomfortable are you with sharing your health information with medical providers?

척도: 17
최소:Very uncomfortable최대:Very comfortable
Q05
의견 척도

How comfortable or uncomfortable are you with sharing your health data with fitness or wearable apps (e.g., Fitbit, Apple Health)?

척도: 17
최소:Very uncomfortable최대:Very comfortable
Q06
순위 매기기

Please rank the following types of health data from most comfortable to least comfortable to share.

  1. Basic profile (age, sex)
  2. Step counts/activity minutes
  3. Heart rate or sleep data
  4. Medication list
  5. Lab results
  6. Mental health notes or assessments
  7. Genetic/ancestry data
드래그하여 순위 지정
Q07
AI 인터뷰

Based on your responses throughout this survey, please share any additional thoughts or feelings about how your health data is shared. What concerns, if any, stand out most to you?

Q08
드롭다운

What is your age?

  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65+
  • Prefer not to say
Q09
메시지

Thank you for completing this survey! Your responses have been recorded and will be used in aggregate to improve health data sharing practices. If you have any questions about this research, please contact the research team.

Q10
객관식

During your most recent visit to a health professional, how did you share information with your provider? Select all that apply.

  • Spoke in person
  • Filled out paper forms
  • Phone call
  • Email
  • Online portal
  • Synced data from a wearable or app
  • Other (please specify)
  • I don't recall
Q11
의견 척도

How comfortable or uncomfortable are you with sharing your health data with patient portals (e.g., MyChart)?

척도: 17
최소:Very uncomfortable최대:Very comfortable
Q12
의견 척도

How important or unimportant is it to you to control who can access your health data?

척도: 17
최소:Very unimportant최대:Very important
Q13
객관식

Which best describes your gender?

  • Man
  • Woman
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q14
의견 척도

How comfortable or uncomfortable are you with sharing your health information with your health insurer?

척도: 17
최소:Very uncomfortable최대:Very comfortable
Q15
의견 척도

How comfortable or uncomfortable are you with sharing your health data with telemedicine or virtual care platforms?

척도: 17
최소:Very uncomfortable최대:Very comfortable
Q16
객관식

Which of the following would most increase your willingness to share health data with a new app or service? Select up to two.

  • Clear explanation of how my data will be used
  • Ability to delete my data at any time
  • Knowing data is stored in my country
  • Endorsement by my doctor or health system
  • Independent security certification
  • Option to share anonymized data only
  • Other (please specify)
Q17
객관식

Do you currently have health insurance coverage?

  • Yes
  • No
  • Prefer not to say
Q18
객관식

In the last 12 months, have you shared any health data directly with your health insurer?

  • Yes — through claims only
  • Yes — via a wellness program
  • Yes — by connecting an app or device
  • Not sure
  • No
Q19
드롭다운

In which region do you currently live?

  • Africa
  • Asia
  • Europe
  • North America
  • South America
  • Oceania
  • Prefer not to say
Q20
드롭다운

What is the highest level of education you have completed?

  • Less than high school
  • High school or equivalent
  • Some college/Associate
  • Bachelor's degree
  • Graduate or professional degree
  • Trade/Vocational
  • Prefer not to say
Q21
객관식

What is your current employment status?

  • Employed full time
  • Employed part time
  • Self-employed
  • Student
  • Homemaker
  • Unemployed
  • Retired
  • Prefer not to say

포함된 기능

  • AI 후속 질문

    정형화된 설문이 놓치는 세부 내용을, 주관식 답변에 맞춰 AI가 심층 질문으로 끌어냅니다.

  • 주의력 확인 장치

    성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.

  • AI가 작성한 문안

    문구, 질문 순서, 분기 로직까지 AI가 연구 목표에 맞춰 작성합니다.

  • 자동 리포트

    응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.

다른 서비스와 비교

다른 설문 도구의 가장 유사한 템플릿을 검토했습니다. 그 도구들이 잘하는 점과, 이 템플릿이 한발 더 나아가는 지점을 정리했습니다.

이 템플릿을 선택하는 이유

  • Uses a series of opinion-scale questions to quantify comfort sharing health data across distinct contexts (primary care providers, fitness/wellness apps, patient portals, telehealth), not just a single generic comfort rating.
  • Includes a ranking question asking respondents to order health data types from most to least comfortable to share, surfacing relative sensitivity rather than isolated yes/no consent.
  • Adds an AI follow-up interview at the end that adaptively probes respondents' own stated concerns and preferences, generating qualitative depth a static form cannot capture.
  • Captures demographic and coverage variables (age, gender, insurance status, region, education, employment) so compliance and privacy teams can segment trust attitudes by population.

SurveySparrow

Patient Consent Form Template

This is a functional patient consent form for authorizing treatment or data use, not a survey designed to measure attitudes toward health data sharing. It's fielding-ready as a form, but it collects signatures/agreement rather than exploring comfort levels, concerns, or trade-offs. Relevant only as an adjacent healthcare-data document, not a comparable attitudes/preferences instrument.

잘하는 점

  • Ready-to-use, healthcare-specific consent template within a broader form/survey builder
  • Likely supports standard customization and mobile-friendly completion
  • Part of a larger library of healthcare templates, easing adoption for clinics

아쉬운 점

  • Captures binary consent/agreement rather than graded comfort levels, ranked preferences, or reasons behind privacy concerns
  • No adaptive AI follow-up to explore why a patient is or isn't comfortable sharing specific data types
  • No per-response quality scoring or transparent prompt methodology for the questions asked

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