Men's Health Awareness Survey Form
Please complete this survey to help us understand awareness and attitudes related to men's health. All responses are anonymous.
How would you rate your overall awareness of men's health issues?
*
1
2
3
4
5
Which of the following sources do you use most often to learn about men's health topics?
*
Healthcare professionals
Websites or online articles
Social media
Friends or family
Other
How often do you visit a healthcare provider for routine check-ups?
*
Once a year or more
Every 2-3 years
Rarely
Never
How strongly do you agree with the following statements about men's health?
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Regular exercise is important for men's health.
1
2
3
4
5
Men should talk openly about their health concerns.
6
7
8
9
10
Preventive health screenings are necessary.
11
12
13
14
15
In the past year, have you participated in any men's health awareness events or campaigns?
*
Yes
No
What do you believe are the biggest barriers to men seeking healthcare?
*
Lack of time
Cost of healthcare
Fear or embarrassment
Not knowing where to go
Other
How comfortable are you discussing men's health topics with others?
*
Not comfortable
1
2
3
4
Very comfortable
5
1 is Not comfortable, 5 is Very comfortable
What men’s health topics do you think need more awareness? (Please specify)
What is your age group?
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55-64
65 or older
Please specify your general location (city or region):
Submit Survey
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