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Youth Health

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Submitted By rajdattavitekar
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Youth Mental Health Survey
By Erudios Pyt Ltd ABN no –

Age:____ Sex: M / F (Need to add 2-3 appealing lines)

Q1) From the following sources with whom do you seek information/help when you are under any stress or problem.

|No |Sources |Never |Sometimes |Often |
|Horoscope | | | | |
|Sex | | | | |
|Relationships | | | | |
|Fashion/Beauty | | | | |
|Success/ Happiness/ Work and Money | | | | |
|Diet/weight loss/ health | | | | |
|Gossips | | | | |
|Movies/TV/Books | | | | |
|Depression | | | | |
|Anxiety | | | | |
|Stress Management | | | | |
|Time Management | | | | |
|Relationship…couples (pre-marriage, enrichment …restoration | | | | |
|Relationships … family | | | | |
|Adolescent Issues (Teenage depression, self esteem, HSC management, sexuality) | | | | |
|Positive mental attitude | | | | |

Q3) How often do you buy magazine? Please tick one from following options

a) Weekly b) Monthly c) Bi-monthly d) 2-5 times/year e) One or less/year

Q4) How much do you usually spend to buy a magazine? You may tick more than one answer.

a) Less than 4$ b) between 4-6$ c) between 8-10$ d) more than 10$

Q5) Have you ever been involved in any type of psychology counseling?

a) YES b) NO (if yes than with whom:______________________)

Q6) Have you used or are you willing to use the following mode of counseling? How much are you ready to pay for these services?

Mode of Counseling |Yes |No |120 | | Face 2 Face | | | | | | | | | |Telephone | | | | | | | | | |Internet via Chat | | | | | | | | | |Internet via E-mail | | | | | | | | | |Other ___________ | | | | | | | | | |

Q7) I would like to read magazine which provides me precise and practical information on youth psychology and problems related with them.

a) Strongly agree b) Agree c) Disagree d) Strongly disagree

Q8) For this type of magazine I am ready to pay….

a) Less than 4$ b) between 4-6$ c) between 8-10$ d) more than 10$

Would you like to member on our network blog. Please provide your e-mail address.

e-mail add:________________________________________

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