COVID-19 Stigma Questionnaire
Help us understand experiences and perceptions related to COVID-19 stigma. Your responses are confidential and will be used for research and awareness purposes.
Your Age
*
Gender
*
Male
Female
Non-binary
Prefer not to say
Other
Occupation
*
Please Select
Healthcare Worker
Essential Worker (Non-Healthcare)
Student
Unemployed
Retired
Other
Have you ever tested positive for COVID-19?
*
Yes
No
Prefer not to say
Has someone close to you (family or friend) tested positive for COVID-19?
*
Yes
No
Prefer not to say
Have you experienced any of the following due to COVID-19? (Select all that apply)
*
Social exclusion or avoidance
Verbal harassment or blame
Loss of employment or educational opportunities
None of the above
Other
To what extent do you agree with the following statements?
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
People who had COVID-19 are often treated differently by others.
1
2
3
4
5
I would feel uncomfortable if a neighbor had COVID-19.
6
7
8
9
10
People avoid those who have recovered from COVID-19.
11
12
13
14
15
I feel safe sharing my COVID-19 status with others.
16
17
18
19
20
Stigma makes it harder for people to seek help if they have COVID-19.
21
22
23
24
25
How would you rate the level of stigma in your community towards people who had COVID-19?
*
No stigma
1
2
3
4
Very high stigma
5
1 is No stigma, 5 is Very high stigma
Have you changed your behavior towards someone because they had COVID-19?
*
Yes
No
Not sure
If you wish, please share any additional comments or experiences regarding COVID-19-related stigma:
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Should be Empty: