Social Isolation Impact Survey
Help us understand how social isolation affects your daily life and well-being. Your responses are anonymous and will be used for research purposes only.
Your Age
*
Gender
*
Female
Male
Non-binary
Prefer not to say
Other
Living Situation
*
Living alone
With family
With roommates
Other
How often do you have in-person social interactions in a typical week?
*
Please Select
0-1 times
2-3 times
4-6 times
7 or more times
How often do you engage in virtual social interactions (video calls, chats, social media) in a typical week?
*
Please Select
Never
1-2 times
3-5 times
6 or more times
Please rate the following statements based on your experience over the past month.
*
Rows
Never
Rarely
Sometimes
Often
Always
I felt lonely
1
2
3
4
5
I felt left out
6
7
8
9
10
I felt isolated from others
11
12
13
14
15
I found it hard to connect with people
16
17
18
19
20
How satisfied are you with your overall social life?
*
1
2
3
4
5
What strategies have you used to cope with social isolation? (Select all that apply)
Calling or messaging friends/family
Engaging in hobbies or interests
Exercise or physical activity
Seeking professional support
Other
How has social isolation affected your emotional well-being?
*
Not at all
1
2
3
4
5
6
7
8
9
Very much
10
1 is Not at all, 10 is Very much
If you have any additional comments or would like to share your personal experience with social isolation, please do so below.
Submit Survey
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