sleepplease
Member
- Joined
- Apr 25, 2006
- Messages
- 328
- Gender
- Female
- HSC
- 2008
Survey for the Youth
Age:……………
Gender:……………
Bold the appropriate answer
Please specify what type of school you attend/attended(Tick all that apply):
□ Private
□ Public
□ Selective
□ International
□ Long Distance/Open High
□ Single Sex
□ Co-education
□ Other (please specify)……………………………………
- Rate the issues from most important to least important in your opinion and/or experience:
□ Healthy food habits
□ Drug use
□ Sexual health
□ Road use
□ Physical activity
- Which of these issues have affected you directly: (i.e. issues you are/have been concerned about or impacted by)
□ Healthy food habits
□ Drug use
□ Sexual health
□ Road use
□ Physical activity
- Which of these issues have affected you indirectly (through family or friends):
□ Healthy food habits
□ Drug use
□ Sexual health
□ Road use
□ Physical activity
4. Did you feel you were given enough information?
□ YES
□ NO
5. Where did you get information from?
□ Doctor- GP
□ Family
□ Friends
□ Psychologist/ Psychiatrist
□ Television
□ School (from teachers or Health Ed classes)
□ Other… (please specify)
___________________________________________
___________________________________________
___________________________________________
6. Did you feel that you were given support?
□ YES
□ NO
- Did you seek any additional support, if yes, in what form?
□ Family
□ Friends
□ Psychologist/ Psychiatrist
□ School Counsellor
□ Teacher
8. Do you drive?
□ YES
□ NO (skip to question 10)
9. Have you ever been in an accident?
□ NO
□ YES – once or twice
□ YES - three or four
□ YES – more than five
10. Have you engaged in any form of sexual activity?
□ YES
□ NO (skip to question 12)
11. Did you feel well informed about any concerns you may have had?
□ YES
□ NO
12. Are you satisfied with your weight/size?
□ YES
□ NO
13. Did you feel well informed about any concerns you may have had?
□ YES
□ NO
14. Have you ever harmed your body to look a certain way (i.e. binge/purge/starve/exercise excessively?
□ YES
□ NO
15. Would you ever consider doing any of the above listed?
□ YES
□ NO
16. Do you take any drugs?
□ NO
□ Yes – alcohol
□ Yes – cigarettes
□ Yes – cocaine
□ Yes – marijuana
□ Yes – ecstasy
□ Yes – acid
□ Yes – other (please specify)
17. How often?
□ Never
□ Once or twice (experimental)
□ At parties/social gatherings
□ Daily
□ Once or twice a week
□ Once or twice a month
18. How often do you exercise?
□ Never
□ One or two days a week
□ Two or three day a week
□ More than four days a week
19. Do you feel that exercise is an important part of a healthy lifestyle?
□ YES
□ NO
20. Where do you exercise?
□ At the gym
□ At home (on exercise equipment)
□ In a park/oval outdoor public venue
□ At school
□ Play a particular sport for which you train
Thankyou for taking the time to complete this survey J
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