2 minutes
Men 18 years of age and older are eligible to fill out this survey.
Do you have any health concerns that you would like to discuss with a healthcare provider?
Have you ever been diagnosed with any chronic health conditions?
Do you have regular health checkups?
Do you eat a balanced and healthy diet?
Do you get enough exercise?
Do you use tobacco products?
Do you drink alcohol?
Do you use drugs?
Do you have any mental health concerns that you would like to discuss with a healthcare provider?
Do you have access to healthcare?
Do you have health insurance?
Do you have a regular doctor or healthcare provider that you see for your health needs?
Do you feel like you are able to talk openly with your healthcare provider about your health needs?
Do you feel like your healthcare needs are being met?
Is there anything else you would like to share about your health or healthcare experiences?