Preventive Care Literacy Survey
Help us understand knowledge and attitudes about preventive healthcare. Your responses are anonymous and confidential.
What is your age group?
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55-64
65 or above
What is your gender?
Female
Male
Prefer not to say
Non-binary/Other
What is your highest level of education?
Please Select
Less than high school
High school diploma or equivalent
Associate degree or vocational training
Bachelor’s degree
Graduate degree or higher
Other
How often do you visit a healthcare provider for routine checkups (not related to illness)?
*
At least once a year
Every 2-3 years
Only when I feel unwell
Rarely or never
Which of the following preventive care services are you familiar with? (Select all that apply)
*
Vaccinations (e.g., flu, COVID-19, tetanus)
Blood pressure screening
Cancer screenings (e.g., mammogram, colonoscopy, Pap smear)
Cholesterol testing
Diabetes screening
Dental checkups
Other
How confident are you in your knowledge about preventive healthcare?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
What do you believe are the main barriers to accessing preventive care? (Select all that apply)
Cost/affordability
Lack of time
Lack of information/awareness
Fear or anxiety about medical visits
Transportation issues
Cultural or language barriers
Other
Please share any additional comments or suggestions regarding preventive care.
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