Blood Knowledge Questionnaire
Please complete this questionnaire to help us assess your knowledge and perceptions about blood.
Full Name
*
First Name
Last Name
Age
*
Gender
*
Male
Female
Prefer not to say
Other
What is your highest level of education?
*
Please Select
Primary School
High School
Undergraduate
Postgraduate
Other
Which of the following is a function of blood?
*
Transporting oxygen
Fighting infections
Regulating body temperature
Producing energy
Other
What is the universal donor blood type?
*
A+
B+
O-
AB+
How often do you think a healthy adult can donate blood?
*
Once a month
Every 2-3 months
Once a year
Never
Please indicate how much you agree with the following statements about blood donation.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Donating blood is safe.
1
2
3
4
5
Blood donation saves lives.
6
7
8
9
10
I am willing to donate blood.
11
12
13
14
15
I am afraid of needles.
16
17
18
19
20
I know where to donate blood.
21
22
23
24
25
How would you rate your knowledge about blood and its functions?
*
1
2
3
4
5
Have you ever donated blood?
*
Yes
No
If you answered 'No' to the previous question, what is the main reason you have not donated blood?
Please Select
Medical reasons
Fear of needles
Lack of information
No time
Other
Please share any additional comments or suggestions about blood donation or knowledge.
Submit
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