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DWARKADAS J SANGHVI COLLEGE OF ENGINEERING, HEALTH AND WELLNESS SURVEY FORM EXTC E3

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

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1

Personal information: Name:

Please share your full name
2

Age:

Please share your age in numbers
3

Gender

Please select your gender
4

Do you know someone who is suffering from a heart disease?

Please select one answer

India faces a major heart health crisis, with about 45 million people affected by cardiovascular diseases. Rising stress, sedentary lifestyles, poor diets, and risk factors like diabetes and hypertension contribute heavily. Experts warn heart disease is now a leading cause of death nationwide. (source:Business-standard.com)

5

How often do you eat unhealthy/junk food?

Please select one answer

Junk food causes obesity, diabetes, heart disease, nutrient deficiencies, poor digestion, mood swings, and low energy, making it harmful for long-term physical and mental health.

6

How often do you get a health checkup?

Please select one answer
7

In a day, how much time do you dedicate to your health, fitness and wellness?

Please select one answer
8

Are you aware of the symptoms of a heart disease?

Please select one answer
9

Do you know the difference between a heart attack and a cardiac arrest?

Please select one answer
10

How stressful is your day to day life?

Please rate on a scale from 1 to 10, 1 being not stressful at all and 10 being highly stressful, (please give points that total to 10 i.e. 7+3 or 6+4, meaning 70% of stress comes from studies and 30% from personal life and vice versa)
Allocate 0.1
Stress related to studies
0
0
10
Stress related to personal life
0
0
10
Any other stress
0
0
10
11

Do you know the first response/first aid for someone having a heart attack infront of you?

Select one answer
12

Do you know about the government schemes about health?

Select one answer

The Government of India and several states run health schemes to address heart diseases. Under Ayushman Bharat – PMJAY, families receive insurance of up to ₹5 lakh for hospitalisation, including heart surgeries. The NPCDCS programme provides screening, early detection, and treatment for cardiovascular diseases at Health and Wellness Centres. State schemes like Mahatma Jyotiba Phule Jan Arogya Yojana in Maharashtra and Vajpayee Arogyasri Yojana in Karnataka offer financial help for heart treatments to poor families. Assam also funds free surgeries for children with congenital heart defects, ensuring timely care. These initiatives reduce costs and improve access to cardiac healthcare.

13

Which of the following doesn't affect your heart health according to you?

Select one or more answers

THANKYOU FOR FILLING THIS FORM!



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