CUENTA GRATIS

Quality of Life Survey Template

The quality of life survey helps collect demographic data as well as quality of life data from a wide range of respondents. These survey questions can be used to collect data about an individual and society on general on various parameters like overall quality of life, natural environment, health, housing, community, overall well-being and community and social culture. The most effective use of this survey is by any council, government, consortium, school or organization to collect data about the quality of life of people that are associated with them.


Spanish (Español) translation missing for :
1. Please select your gender
Spanish (Español) translation missing for : 2. What is your highest education level completed?
Spanish (Español) translation missing for : 3. What is your marital status?
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4. What is your ethnicity?
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5. Please select your employment type
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6. During the past 6 months, you have lived: (select all that is applicable)
Spanish (Español) translation missing for : 7. Please select your housing type
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8. Please select the most appropriate answer options
Spanish (Español) translation missing for : Strongly Agree
Spanish (Español) translation missing for : Agree
Spanish (Español) translation missing for : Neutral
Spanish (Español) translation missing for : Disagree
Spanish (Español) translation missing for : Strongly Disagree
Spanish (Español) translation missing for : I am happy with the house I live in
Spanish (Español) translation missing for : I am satisfied with the hygiene around the house
Spanish (Español) translation missing for : My neighbors are good
Spanish (Español) translation missing for : I am satisfied with the food that I eat
Spanish (Español) translation missing for : I am happy with the clothes I wear
Spanish (Español) translation missing for : I have a decent paying job
Spanish (Español) translation missing for : I hang out with my friends quite often
Spanish (Español) translation missing for : I am satisfied with my personal safety
Spanish (Español) translation missing for : I pursue at least one hobby
Spanish (Español) translation missing for : I have a healthy relationship with my parents
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9. How important are the following aspects of your life?
Spanish (Español) translation missing for : Not at all important
Spanish (Español) translation missing for : Slightly important
Spanish (Español) translation missing for : Moderately important
Spanish (Español) translation missing for : Very important
Spanish (Español) translation missing for : Extremely important
Spanish (Español) translation missing for : Having a good house to stay in
Spanish (Español) translation missing for : The way I spend my time on a regular basis
Spanish (Español) translation missing for : I need good food to eat
Spanish (Español) translation missing for : I need to mentally healthy
Spanish (Español) translation missing for : I need a good means of transportation
Spanish (Español) translation missing for : A healthy sex life
Spanish (Español) translation missing for : 10. Which of the following would be your regular activity? Select all that is applicable
Spanish (Español) translation missing for : 11. Please select Yes or No for each of the following questions.
Spanish (Español) translation missing for : Yes
Spanish (Español) translation missing for : No
Spanish (Español) translation missing for : I am happy about achieving something good in the last 4 weeks.
Spanish (Español) translation missing for : I feel left out and odd with people around me
Spanish (Español) translation missing for : I am bored very easily
Spanish (Español) translation missing for : Lack of concentration in the last 4 weeks
Spanish (Español) translation missing for : Extremely restless and jumpy
Spanish (Español) translation missing for : Have put on a lot of weight in the last 6 months
Spanish (Español) translation missing for : Happy because I received compliments from family and friends
Spanish (Español) translation missing for : Depressed and unhappy
Spanish (Español) translation missing for : Particularly excited about something
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12. How would you rate your mental health over the past 4 weeks?
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13. How would you rate your physical health over the past 4 weeks?
Spanish (Español) translation missing for : 14. Have you ever been for psychiatric consultation?
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15. How often do you consume alcohol?
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16. Do you use drugs or any other substance?
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17. How often do you consume drugs?
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18. How often does lack of money keep you from doing the things you wish to do?
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19. Please select all the activities you have done in the past 4 weeks
Spanish (Español) translation missing for :
20. How important are the following factors in determining your quality of life?
Spanish (Español) translation missing for : Not at all important
Spanish (Español) translation missing for : Slightly important
Spanish (Español) translation missing for : Moderately important
Spanish (Español) translation missing for : Very important
Spanish (Español) translation missing for : Extremely important
Spanish (Español) translation missing for : Work/school
Spanish (Español) translation missing for : How you feel about yourself
Spanish (Español) translation missing for : Your physical state of being
Spanish (Español) translation missing for : Your mental state of being
Spanish (Español) translation missing for : Your family/ friends
Spanish (Español) translation missing for : Your bank balance

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