Website survey


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Website Survey

We would appreciate your feedback on the Headache Australia website � please take a few minutes to answer the following questions and send in to us.

How did you learn about the Headache Australia website?

How often do you visit the Headache Australia website?

How would you rate the ease of use of the Headache Australia website?
(1=Easy, 5=Difficult)

	1
	2
	3
	4
	5

Did you find the information you were seeking?

	Yes
	No

If not, what was it?

Have you used the search feature?

	Yes
	No

Was it helpful to you?
(1=Not Helpful, 5=Very Helpful)

	1
	2
	3
	4
	5

What other websites do you use for medical information?

What else would you like to see offered on the Headache Australia website?

Are you a Headache Australia Club Member?

	Yes
	No

What other information and service would you like offered to members?

Have you used the Headache Australia Club Members online forum?

	Yes
	No

If yes, what was your opinion of it?
(1=Poor, 5=Excellent)

	1
	2
	3
	4
	5

What is your age?

Gender:

	Male
	Female

For how many years have you suffered from headaches?

What type of headache do you suffer from?
(Tick all that apply)

	Migraine
	Tension-type
	Cluster
	Rebound
	Sinus
	Chronic Daily Headache
	Don't Know

If other, please specify

Have you been diagnosed by a doctor?

	Yes
	No

If yes, what type of doctor diagnosed you?

	Primary Care (General Practitioner)
	Neurologist
	Other

If other, please specify

For how many years did you suffer before receiving a diagnosis?

Are you currently being treated for your headaches?

	Yes
	No

What type of medication(s) are you taking for your headaches?
(Tick all that apply)

	Non-prescription pain-reliever (over-the-counter)
	Prescription pain-reliever
	Herbal/Vitamin/Other Supplement
	Other

Please specify your acute medication

How satisfied are you with your acute headache treatment?
(1=Not at all, 5=Very satisfied)

	1
	2
	3
	4
	5

Your Name *

Your Email *

(* denotes a mandatory field)

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