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Hygiene Survey

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

Secured
1

Do you wash your hands regularly?

Choose the option that best fits your situation
2

Rate the cleanliness of your living environment

Rate from 1 to 10 (1 being very dirty, 10 being very clean)
3

How often do you brush your teeth?

Please provide a brief description
4

Do you disinfect commonly touched surfaces regularly?

Choose the option that best fits your situation
5

How often do you change your bed sheets?

Choose the option that best fits your situation
6

Rate your personal hygiene routine

Rate from 1 to 10 (1 being very poor, 10 being excellent)
7

Do you cover your mouth when sneezing or coughing?

Choose the option that best fits your behavior
8

How often do you clean your bathroom?

Choose the option that best fits your cleaning frequency
9

Describe your handwashing routine

Provide details about when and how you wash your hands
10

Rate how important hygiene is to you

Rate from 1 to 10 (1 being not important, 10 being very important)