1. Questionnaire
Name of respondents- Date- / / 2012
Age- Gender - Male Female
Occupations-
1- Do you ever go online to access the Internet or World Wide Web or to send
and receive email?
A. Yes ()
B. No ()
C. Some Time ()
2 -How often do you use the Internet to look for advice or information about
health or health care.
A. About once a week ()
B. Once in a month ()
C. Every few month ()
D. Not use ()
3. Did the information you got online affect any of your decisions about health
treatments.
A. Strongly agree ()
B. Agree ()
C. Neither agree nor disagree ()
D. Disagree ()
E. Strongly Disagree ()

2. 4. You can get health information online any time, whenever it’s convenient for
you.
A. Strongly agree ()
B. Agree ()
C. Neither agree nor disagree ()
D. Disagree ()
E. Strongly Disagree ()
5. Online health service provide you full details about your disease
A. Strongly agree ()
B. Agree ()
C. Neither agree nor disagree ()
D. Disagree ()
E. Strongly Disagree ()
6. Were you looking for health information for ?
A. Yourself ()
B. Child ()
C. Parents ()
D. Relative ()
E. Not for any one ()
7. About how many different web sites did you go to when you were looking for
this health information?
A. One ()
B. Two or five ()
C. Five to Ten ()
D. More than 10 ()
E. Not visit ()

3. 8. How much of the health information you see on the Internet do you think you
can believe.
A. Strongly agree ()
B. Agree ()
C. Neither agree nor disagree ()
D. Disagree ()
E. Strongly Disagree ()
9. Getting health information from online is an unreliable
A. Strongly agree ()
B. Agree ()
C. Neither agree nor disagree ()
D. Disagree ()
E. Strongly Disagree ()
10. Do you describe medical condition or problem online in order to get advice
from an online doctor?
A. Strongly agree ()
B. Agree ()
C. Neither agree nor disagree ()
D. Disagree ()
E. Strongly Disagree ()
11. Do you look health information BEFORE visiting a doctor or clinic for a
consultation?
A. Strongly agree ()
B. Agree ()
C. Neither agree nor disagree ()
D. Disagree ()
E. Strongly Disagree ()

4. 12. Overall, how much USEFUL online health service?
A. Very useful ()
B. Somewhat useful ()
C. Not too useful ()
D. Not at all useful ()
13. Did you later visit the web site for online appointment?
A. Strongly agree ()
B. Agree ()
C. Neither agree nor disagree ()
D. Disagree ()
E. Strongly Disagree ()
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