How we breathe feedback form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The survey should only take a few minutes and will provide valuable information to evaluate the video "How We Breathe" produced by IPCRG.

Thanks for agreeing to take part in our survey!

The IPCRG team

Please indicate your gender *

Male

Female

Other:

Please advise your level of academic qualifications *

Less than Primary education

Primary education

Lower secondary education

Upper secondary education

Post-secondary non-tertiary education (e.g. apprenticeship or training, not university)

Short-cycle tertiary education (e.g. community colleges, technician or advanced/higher vocational training )

Bachelor’s or equivalent level

Master’s or equivalent level

Doctoral or equivalent level

If you are a healthcare professional, please describe your role *

GP or Family Physician

Nurse

Pharmacist

Physiotherapist

Pulmonologist

I'm not an health care professional

Other:

What country do you live in? *

What year were you born? *

Do you have any respiratory problems? *

Yes

For the remaining questions please choose the answer from the scale

What was your overall impression of the video?
*

Very good

Good

Neutral

Poor

Very poor

Would you recommend your friends or family to watch this video?
*

Very unlikely

Somewhat unlikely

Neutral

Somewhat likely

Very likely

If you are a healthcare professional, would you recommend your colleagues to watch this video?
*

Very unlikely

Somewhat unlikely

Neutral

Somewhat likely

Very likely

I'm not a health care professional

Did you share this video with anyone else? *

Yes

Would you be interested in watching more videos like this one?
*

Definitely yes

Probably yes

Neutral

Probably no

Definitely no

How do you rate the video’s duration?
*

Too long

Long

Adequate

Short

Too short

Do you think the video’s messages were easy to understand?
*

Definitely yes

Probably yes

Neutral

Probably no

Definitely no

After watching the video, were you curious to learn more about respiratory health?
*

Definitely yes

Somewhat yes

Neutral

Somewhat no

Definitely no

If you have any respiratory problem, do you think this video can be helpful in improving your management of your breathing?
*

Definitely yes

Probably yes

Neutral

Probably no

Definitely no

I don't have a respiratory problem

If you are a healthcare professional, do you think this video can be helpful in your day-to-day work?
*

Definitely yes

Probably yes

Neutral

Probably no

Definitely no

I'm not a health care professional

Where did you find this video?
*

IPCRG website

IPCRG Newsletter

Facebook

Instagram

Twitter

Shared by a colleague - including IPCRG invited specialists, associate member organisations and our Senate

Other:

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of International Primary Care Respiratory Group.

Does this form look suspicious? Report

Forms