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Survey about Dengue Fever
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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1
What is your age?
Please provide your age in years.
Under 18
18-30
31-45
46-60
Above 60
2
Have you been diagnosed with Dengue Fever in the past?
Please rate your experience with Dengue Fever from 1 to 10.
3
What gender do you identify with?
Please select your gender.
Male
Female
Other
4
Do you know the common symptoms of Dengue Fever?
Please select 'Yes' if you are aware of the symptoms, and 'No' if you are not.
Yes
No
5
How would you rate your knowledge about Dengue Fever prevention methods?
Please rate your knowledge from 1 to 10.
6
What measures do you take to prevent Dengue Fever?
Please provide a brief description.
7
In your opinion, how serious is Dengue Fever as a health concern?
Please rate the seriousness from 1 to 10.
8
Have you ever been vaccinated against Dengue Fever?
Please select 'Yes' if vaccinated, and 'No' if not.
Yes
No
9
Do you have any specific questions or concerns about Dengue Fever?
Please feel free to ask any questions or share your concerns.
10
Would you like to receive more information about Dengue Fever?
Please select 'Yes' if interested, and 'No' if not.
Yes
No
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