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Pneumonia Disease Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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PNEUMONIA QUESTIONNAIRE
1
Have you or someone you know ever been diagnosed with pneumonia?
Please select one of the following options.
Yes
No
Not sure
2
On a scale of 1 to 10, how severe do you consider pneumonia to be?
Please rate pneumonia on a scale of 1 to 10, with 10 being the most severe.
3
Please share any additional information or experiences you have had with pneumonia.
Please provide a detailed response.
4
Do you know the common symptoms of pneumonia?
Please select one of the following options.
Yes
No
Not sure
5
What do you think is the best way to prevent pneumonia?
Please choose the option you believe is most effective.
Vaccination
Proper hand hygiene
Avoiding smoking
Healthy lifestyle choices
6
How familiar are you with the different types of pneumonia?
Please rate your familiarity on a scale of 1 to 10, with 10 being very familiar.
7
Have you received a pneumonia vaccine?
Please select one of the following options.
Yes
No
Not applicable
8
Do you believe pneumonia is a serious health concern?
Please select one of the following options.
Yes
No
Not sure
9
How well-informed do you feel about pneumonia?
Please rate your level of information on a scale of 1 to 10, with 10 being very well-informed.
10
Do you think enough awareness is raised about pneumonia in the community?
Please select one of the following options.
Yes
No
Not sure
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