I don't mind doing surveys but that first page makes it look like I'm at the doctor's office for the first time.
Informed consent? Five "I agree that..." statements and a confirmation of such before I can proceed? Sorry but you will need to pay me for my time. You are WAY overthinking this.
Simply replace that with just one statement "All information provided by you is anonymous and will not be shared with any outside parties other than the researcher themselves. After the results have been analysed, the information collected will be destroyed." followed by a button "begin survey".
Then, please post your survey in TravelBuzz, not here. Here, all you will get is a bunch of responses from people who fly (and a handful of people who hate) Southwest Airlines. Your results will be very skewed.