RH Survey COVID-19

The Good Life
Quality of life is a subjective concept that looks at the ability to comfortably enjoy one’s life. It is often measured in terms of your emotional and physical well-being. It can sometimes affect the decisions and choices we make in our lives. Please take our survey and let Real Health know about your quality of life.
1) How would you rate your overall quality of life?

Very goodGoodPoorVery poorNeither good nor poor
2) How much do you worry about your health?

Very muchA moderate amountA littleNot at all
3) How much do you worry about your ability to access medical care?

Very muchA moderate amountA littleNot at all
4) Does physical pain ever prevent you from doing what you want to do?

YesNo
5) Do you get tired easily?

YesNo
6) Do you have any mobility issues?

YesNo
7) Are you satisfied with the quality of your medical care?

Very satisfiedSatisfiedDissatisfiedVery dissatisfiedNeither satisfied nor dissatisfied
8) Do you consider quality of life when making treatment decisions?

YesNo
9) Have you ever chosen a treatment because it would increase your quality of life?

YesNo
10) Have you ever declined a treatment because it would decrease your quality of life?

YesNo
11) How often do you experience feelings of despair, anxiety or depression?

AlwaysOftenSeldomNever
12) Do make time to enjoy your life?

YesNo
13) Do you have any difficulty sleeping?

YesNo
14) Are your sexual needs fulfilled?

YesNo
15) Are you satisfied with your personal relationships?

Very satisfiedSatisfiedDissatisfiedVery dissatisfiedNeither satisfied nor dissatisfied
16) How much do you worry about money?

Very muchA moderate amountA littleNot at all
17) Are you satisfied with your current living conditions?

Very satisfiedSatisfiedDissatisfiedVery dissatisfiedNeither satisfied nor dissatisfied
18) What year were you born?
19) What is your gender?

MaleFemaleTransgenderOther
20) What is your sexual orientation?

StraightGay/lesbianBisexualOther
21) What is your current level of education?

Some high schoolHigh school graduateSome collegeBachelor’s degree or higher
22) What is your household income?

Under $15,000$15,000 - $34,999$35,000 - $49,999$50,000 - $74,999$75,000 - $99,999$100,000 and over
23) What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
24) What is your zip code?
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The Good Life