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StraightTalk Web Site Survey

1. Which of the following best describes why you came to the website today?
Prefer not to answer
I am looking for health information for myself
I am looking for health information for someone I care about
I am a healthcare professional looking for information about what treatments would be helpful for my patients
Some other reason
2. What is your current age?
3. What is your gender?
Prefer not to answer
Male
Female
4. Where did you hear about this website?
Newspaper
Billboard
Radio Advertisement
Doctor's Office
Received information in the mail
Magazine
Friend
Partner
Online Search
Other
5. Have you ever talked to a doctor about Erectile Dysfunction?
Prefer not to answer
Yes
No
6. Have you ever received treatment for ED?
Prefer not to answer
Yes
No
If you answered yes to question 6, what treatments were you prescribed? Please check all that apply
Prefer not to answer
Oral medication
Injection
Oral testosterone
Insertable drugs (e.g. Muse)
Vascular Surgery
Vacuum Devices
Penile Implant
If oral medication, what type:
7. Did you find the information that you were looking for?
Yes
No
If you answered no to the above question, what information were you looking for that you were unable to find on the website?
8. Considering everything you know about Erectile Dysfunction and the surgical alternative, how likely would you be to attend a free local seminar in your area?
Definitely will attend
Probably will attend
Might attend
Would not attend
Would not attend but would like more information on treatment options sent to me in the mail
If you want more information from question 8, please enter your mailing address in the box provided below:
9. Considering everything you know about penile implants, how likely are you to seek out a Urologist who specializes in penile implants?
Definitely will look for a doctor who specializes in penile implants
Probably will look for a doctor who specializes in penile implants
Might look for a doctor who specializes in penile implants
Probably will not look for a doctor who specializes in penile implants
Definitely would not look for a doctor who specializes in penile implants
10. How would you rate the overall usefulness of this Web site?
Excellent
Very Good
Good
Fair
Poor
Don't know
11. Was the information on this website easy for you to understand?
Yes
No

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