Survey-WB – 031 Consulting

Full Name *

First and Last Name

Email *

Type your Email address

Phone number *

Type your phone number

Your Monthly Gross Income *

Less than R20,000 per month

R20,000 - R35,000 per month

R35,000 - R50,000 per month

R50,000 - R80,000 per month

R80,000 - R120,000 per month

R120,000 - R200,000 per month

R200,000 or more per month

Do You Have Any Of The Following In Place?

Which Of The Following Is The Most Important To You?

Do You Know The Risks Of Not Having The Right Medical Aid Cover?

Yes

No

When Was Your Last Portfolio Review

Less then a year ago

More then 2 years ago

More Then 5 Years Ago

I've never had a portfolio Review

How Much Do You Want To Save On Your Cover Each Year

R0 - R5,000

R5,000 - R15,000

R15,000 - R30,000

More Then R30,000

What Time Of Day Is Best For Me To Call You.

Morning (08:00 - 12:00)

Lunchtime (12:00 - 13:00)

Afternoon (13:00 - 17:00)

Evening (17:00 - 18:00)