Reveal - Liver health patient survey

About You

All information is private and confidential. No identifying information will be used in any publication, report or recommendations that arise from this survey.

If you require further information or would like to provide feedback on this survey, please contact Martin Forrest, Health Promotion Programs Manager at Hepatitis Victoria
martin@hepvic.org.au (03) 9385 9111

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* 1. How old are you?

18 – 24

25 – 34

35 – 44

45 – 54

55 – 64

65 – 74

74+

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* 2. How do you identify your gender?

Male

Female

Prefer not to say

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* 3. What is your postcode?

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* 4. Are you Aboriginal or Torres Strait Islander?

Yes

Prefer not to say

Reveal - Liver health patient survey

About You

Question Title

* 1. How old are you?

Question Title

* 2. How do you identify your gender?

Question Title

* 3. What is your postcode?

Question Title

* 4. Are you Aboriginal or Torres Strait Islander?

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* 5. What language do you speak at home?