Body Image Survey
Please take a few minutes to complete this survey about body image.
How satisfied are you with your body image?
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
What factors influence your body image? (Select all that apply)
Media
Social media
Family
Friends
Peers
Culture
Personal experiences
Other
What are your thoughts and feelings towards your body?
Do you compare your body to others?
Yes
No
If you answered 'Yes' to the previous question, how often do you compare your body to others?
Please Select
Frequently
Sometimes
Rarely
Never
Have you ever experienced body shaming or negative comments about your body from others?
Yes
No
If you answered 'Yes' to the previous question, how did these experiences impact your body image?
Submit
Should be Empty: