Survey Questions
1. What age group are you in?
2. Do you know what a psychiatrist is? Please circle
Yes or No
3. Have you ever needed a psychiatrist? Please circle.
Yes or No
4. Why did you need or have a psychiatrist? Please explain
5. Have you been diagnosed with anything? Check all that apply.
Depression__ Bipolar__ Anxiety__ Social Anxiety__ Other__
Please write anything else
___________________________
6. Do you have a psychiatrist now?
Yes or No
7. What do you do when you are stressed? Check all that apply.
Music__ TV__ Other__
8. Who do you go to when you are stressed?
Parents__ Friends__ Religion__ Deal with it__ Other__
9. How important do you think psychiatry is? Please circle one. 1 being the and 10 being the highest.
1 2 3 4 5 6 7 8 9 10
10. Would you prefer a male or female psychiatrist?
Male__ Female__ Doesn’t Matter__
11. Who do you think should be responsible for someone to get psychological help? (if person is under 18) check all that apply.
Parents__ The Patient__ Teacher__ All__
12. How did you get in contact with your psychiatrist? Please explain
_______________________________________________
13. Do you think a psychiatrist can really sympathize with their patient?
Yes or No
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