Real Health Winter 2012: Hepatitis C Awareness

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Real Health Winter 2012: Hepatitis C Awareness

Recently, the Centers for Disease Control and Prevention suggested all people born in 1945 through 1965 get a one-time blood test for hepatitis C, whether or not they believe they're at risk of the illness. The hep C virus causes liver damage; you can contract it when infected blood enters your bloodstream. Most commonly, this can happen if you share needles or even contaminated personal items, such as razors, or if you had a blood transfusion before 1992.

Please fill out the survey below to tell us your thoughts about hepatitis C.
 
1. Do you think you're at risk of hepatitis C?
Yes
No
Not sure
 
2. Have you ever discussed hepatitis C with your doctor?
Yes
No
Not sure
 
3. Do you understand the five different types of hepatitis?
Yes
No
Not sure
 
4. Do you know anyone with hepatitis C?
Yes
No
Not sure
 
5. Are you aware of the warning signs of hepatitis C infection?
Yes
No
Not sure
 
6. Do you know the best ways to protect yourself from hepatitis C?
Yes
No
Not sure
 
7. Do you know the ways in which hepatitis C is transmitted?
Yes
No
Not sure
 
8. Do you think hepatitis C can be cured?
Yes
No
Not sure
 
9. Name:
 
10. Organization (if you represent one):
 
11. Street address:
 
12. City & state:
 
13. Zip code:
 
14. Email:
 
15. Phone:
 
16. What year were you born? (e.g., 1975)
 
17. What is your gender?
Female
Male
Transgender
Other
 
18. What is your household income?
Under $15,000
$15,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 and over
 
19. What is the highest level of education attained?
Some high school
High school graduate
Some college
Bachelor's degree or higher
 
20. What is your ethnicity?
American Indian or Alaska Native
Arab or Middle Eastern
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Other
 
21. Where do you get Real Health?
I'm a subscriber
My doctor's office
My church
A community or college organization
It was mailed to me
Other: 
 
22. Do you have Internet access?
Yes
No


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