Medical Web Use example

This is an example Medical Web Use survey. This survey includes questions like:

We hope this will help you create your own Medical Web Use survey. We have not tested the validitiy or reliability of this survey. However, you may use this as a starting point to help your own survey instrument. Feel free to change and edit any of our survey templates to help you get started.

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1) Do you have a primary care or regular physician?
2) How long have you been seeing your primary care or regular physician?
3) What is your regular physician's area of practice?
  • General/Family Practice
  • Medical Specialty
  • Other:
4) Has your physician ever recommended any medical websites to you?
5) What medical websites has your physician recommended to you?
6) How often have you used the Internet to obtain medical information?
  • Often
  • Sometimes
  • Rarely
  • Never (go to question 11)
7) What websites do you usually visit for medical information?
8) How often have you discussed medical information you have obtained from a website with your physician?
9) How has your physician reacted when you have discussed medical information you obtained from the Internet?
  • Welcomed and openly discussed the information
  • Dismissed the information with little discussion
  • Became irritated and recommended not using the internet for medical information
  • Other:
10) In what ways has obtaining medical information from the internet helped your relationship with your physician regarding your health care? (Check all that apply)
  • Feel like more of a partner in my health care
  • Helps me to better communicate with my doctor
  • Feel more informed about my health care and treatment options
  • Gives me more control over my health care
  • Other:
11) How often have you diagnosed and treated your symptoms using medical information from the internet instead of seeing your physician?
12) Are you male or female?
13) What is your age?
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