This is an example Medical Web Use survey. This survey includes questions like:
Do you have a primary care or regular physician?
How long have you been seeing your primary care or regular physician?
What is your regular physician's area of practice?
We hope this will help you create your own Medical Web Use survey. We
have not tested the validitiy or reliability of this survey. However, you may
use this as a starting point to help your own survey instrument. Feel free to
change and edit any of our survey templates to help you get started.