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LGBT Media Survey Questions + Sample Questionnaire Template

The Lesbian, Gay, Bisexual, & Transgender (LGBT) media survey template consists of questions for evaluating and understanding the reach of media and its use by the LGBT community. This sample questionnaire template was created by industry experts to bring you insightful responses about how the community attitude in general towards the LGBT community be improved. It consists of multiple survey questions that collect demographics information and in-depth information about the perception of the LGBT community and their if the use of media can alter that perception.


What is your gender?
What is your sexual orientation?
Who are you out to?
What is your age?
What is your partnership status?
What is your highest level of education?
What is your race? (Please check all that apply.)
What is your current employment status?
What industry are you employed in?
How many hours a week of television do you watch?
Where do you live?
What is your annual household income?
For each of the choices below, please indicate the extent of your media usage.
Never
Rarely
Occasionally
Frequently
Very Frequently
Newspapers
Magazines
Internet
Television
Radio
Theatre
Film/Cinema (Outside the home)
For each of the choices below, please indicate the extent of your television viewing.
Never Watch
Rarely Watch
Watch Occasionally
Watch Frequently
Watch Very Frequently
Cable Networks (Including ABC, NBC, FOX, etc.)
Cable News Networks (Including CNN, MSNBC, etc.)
Public Television (Including National, Regional, or Local)
Premium Cable Networks (Including HBO, Showtime, Cinemax, etc.)
Music Television Networks (Including MTV, VH1, CMT, etc.)
International/World Networks (Including BBC, etc.)
LGBT Networks (Including Logo, Here!, QTV, etc.)
For each of the television networks listed below, please indicate your exposure and viewing frequency.
Never Heard of
Never Watch
Rarely Watch
Watch Occasionally
Watch Frequently
Watch Very Frequently
Logo
Here! TV
Q Television Network
For each of the programs listed below, please indicate your exposure and viewing frequency.
Never Heard of
Never Watch
Rarely Watch
Watch Occasionally
Watch Frequently
Watch Very Frequently
In the Life
Will & Grace
The Ellen Degeneres Show
The L Word
Queer as Folk
Round Trip Ticket
Wisecrack
Graham Norton
Noah’s Ark
Open Bar
Never Heard of
Never Watch
Rarely Watch
Watch Occasionally
Watch Frequently
Watch Very Frequently
It’s All Relative
Queer Eye for the Straight Guy
Queer Eye for the Straight Girl
Sex and the City
The Suze Orman Show
60 Minutes
Huff
Extreme Makeover: Home Edition
Desperate Housewives
Law & Order
Never Heard of
Never Watch
Rarely Watch
Watch Occasionally
Watch Frequently
Watch Very Frequently
Project Runway
America's Next Top Model
Survivor
The Apprentice
For each of the magazines and periodicals listed below, please indicate your exposure and viewing frequency of both print and online editions.
Never heard of
Never Read
Rarely Read
Read Occasionally
Read Frequently
I’m a Subscriber
Local / Regional LGBT Newspapers and/or Magazines
Local / Regional Mainstream Newspaper and/or Magazines
The New York Times
The Wall Street Journal
Genre
The Advocate
Out
Details
GQ
Cargo
Never heard of
Never Read
Rarely Read
Read Occasionally
Read Frequently
I’m a Subscriber
Men's Health
Esquire
Domino
Time
Newsweek
People
US Weekly
Real Simple
InStyle
Vogue
Never heard of
Never Read
Rarely Read
Read Occasionally
Read Frequently
I’m a Subscriber
Vanity Fair
W
Curve
Instinct
Out Traveler
Architectural Digest
Passport
Pride
Girlfriends
Scene
Never heard of
Never Read
Rarely Read
Read Occasionally
Read Frequently
I’m a Subscriber
Gay & Lesbian Review Worldwide
For each of the statements below, please indicate the extent of your agreement or disagreement.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
I prefer companies who advertise to LGBT consumers in LGBT media.
I would like to see more companies advertise to LGBT consumers in mainstream media.
I actively seek out companies who advertise directly to LGBT consumers when making purchasing decisions.
I actively seek out companies who support the LGBT community when deciding what products and/or services to buy.
Given the choice between two comparable products (same features & price) from a brand that advertises to LGBT consumers, and a brand that does not advertise to LGBT consumers, I would purchase from the brand that advertises to LGBT consumers.
I prefer LGBT media to mainstream media.
I prefer to read newspapers that print same-sex announcements.
I support civil unions and/or domestic partnerships.
I support extending marriage to same-sex couples.
I prefer online news media to print news media.
For each of the statements below, please indicate the level of importance to you.

Unimportant
Of little Importance
Moderately Important
Important
Very Important
Strengthening hate crime legislation and including provisions for LGBT individuals.
Corporate nondiscrimination policies that include gender (or perceived gender) and protection for LGBT individuals.
Extending the protections and benefits of marriage to same-sex couples.
Providing safe school environments across the country so that LGBT students are protected from discrimination and violence.
Increasing LGBT characters in television programming.
Increasing the reporting of LGBT newsworthy events on primetime news programs.
Increasing diversity programs and awareness in schools.
For each of the genres below, please indicate your interest and likelihood of viewing the following types of programming.
Never
Probably Not
Possibly
Probably
Definitely
Travel
Music
Comedy
Movies
Drama
Sitcom
News
Documentary
Sports
Finance
Never
Probably Not
Possibly
Probably
Definitely
Talk Shows
Home Decorating / Interior Design
Game Shows
Reality Shows
Celebrity-based Shows
Political Discussion / Debate
Health & Wellness
Animals & Wildlife
History
International Programming
Please indicate your interaction with the following brands over the past 12 months. 
Never heard and never purchase
Heard but never purchased
Heard of and also purchased
Eastman Kodak
Continental Airlines
United Airlines
Ameriprise Financial
eBay
Dell Computer
Apple Computer
Bacardi
Motorola
General Motors (Including Pontiac & Saab)
Never heard and never purchase
Heard but never purchased
Heard of and also purchased
Subaru
American Express
E*Trade
Earthlink
Glaxo SmithKline
Johnson & Johnson
Hewlett Packard
Travelocity
Miller Brewing
Anheuser-Busch
Never heard and never purchase
Heard but never purchased
Heard of and also purchased
The New York Times
Lions Gate Films
Tower Records
1-800-Mattress
Sleepy’s
Sharper Image
Orbitz
Toyota
ABC Carpet & Home
1-800-PetMeds
Never heard and never purchase
Heard but never purchased
Heard of and also purchased
Avis
Allstate
Procter & Gamble
Kraft Foods
Hyundai
Amstel Light
Kenneth Cole
Ikea
T-Mobile
John Hancock Financial Services
Never heard and never purchase
Heard but never purchased
Heard of and also purchased
Mercedes-Benz
California Closets
IBM
Hyatt Resorts
Jaguar
Land Rover / Range Rover
Volvo
JPMorgan / Chase
Bridgestone Tires
Audi
Never heard and never purchase
Heard but never purchased
Heard of and also purchased
Absolut
Do you agree with the following?
Yes
Maybe
No
Will LGBT television networks (like LOGO) improve attitudes toward the LGBT community?
Will ads on LGBT television networks improve attitudes toward the LGBT community?
Will LGBT television networks provide a broader portrayal of LGBT characters?


Are you interested in participating in future research studies?

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