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One-on-One Health Education 健康教育問卷
您接受什麼健康教育？What type of cancer education you took?
*
乳癌 Breast Cancer
大腸癌 Colorectal Cancer
結腸直腸(大腸)癌 篩檢的重要性
名 First Name
姓 Last Name
郵箱 Email
郵編 Zip code
電話號碼 Phone
性别 Sex：
*
男Male
女Female
1. How did you hear about the educational event?您怎麼聽說這次的活動？
*
Light and Salt Association光鹽社
Newspaper 報紙
TV 電視
Radio 電台
Internet 網路
Church 教會
Friends 朋友
Doctor 醫生
Your age 年齡
*
19 and under 19歲以下
20-39
40-49
50-64
65 and above 65以上
Your highest level of education? 您的教育程度
Did not complete high school 未完成高中
High school/GED 高中程度
Bachelor's degree 大學
Master’s degree 研究所
Advanced graduate work, professional degree or Ph.D.博士
The county you live in? 郵政區號
Have you ever had any cancer screening test, which relative to this cancer before? 您是否有做過此癌症的檢查？
*
Yes 有
No 沒有
The content of the education enhances my knowledge of this cancer type.
Strongly Disagree
Disagree
Agree
Strongly Agree
Excellent
I know which population is at risk of colon cancer.
Strongly Disagree
Disagree
Agree
Strongly Agree
Excellent
I know the signs/symptoms of colon cancer. 我知道此癌症的症狀
Strongly Disagree
Disagree
Agree
Strongly Agree
Excellent
I know when I need to have a colon cancer screening.我知道什麼時候該檢測該病
Strongly Disagree
Disagree
Agree
Strongly Agree
Excellent
I will recommend this information to others. 我會推薦別人此教育
Strongly Disagree
Disagree
Agree
Strongly agree
Excellent
13. Do you have any suggestions for us? 您有任何建議嗎？
Thanks for submitting!
Submit
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