Summary

This is the appendix to the report: "The Likelihood of Enrolment: Evidence from Haryana." It contains the questionnaire used for a survey conducted among the households of the Indian state of Haryana concerning the enrolment to "Rashtriya Swasthya Bima Yojna" (RSBY), a voluntary, Government sponsored health insurance scheme for poor households started in April 2008. The aim of this survey was to analyze how socio-economic and demographic factors influence the enrolment to RSBY.