QuestionPunkQuestionPunk
無料で始める
すべてのテンプレート
Industry-Specific

Sexual Health Testing Experience & Awareness Survey

Measures how people access, experience, and think about STI/STD testing services — testing frequency, comfort with providers, and the practical or emotional barriers that keep people from testing regularly. Built for sexual health clinics and public health teams, with an AI follow-up that digs into the real reasons behind gaps in testing behavior.

このテンプレートを使うほかのテンプレートを見る

設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全13問・約7分
Q01
メッセージ

Thanks for taking a few minutes to share your experience with sexual health testing. Everything you share is confidential and there are no wrong answers — this should take about 4-5 minutes.

Q02
選択式必須

In the last 12 months, how many times have you been tested for STIs?

  • Never
  • Once
  • Two or three times
  • Four or more times
  • I'm not sure / can't recall
Q03
選択式

Where have you gotten tested for STIs before (select all that apply)?

  • Primary care doctor's office
  • Sexual health / STI clinic
  • Pharmacy or urgent care
  • At-home test kit
  • Community health event or outreach van
  • I have never been tested
Q04
オピニオンスケール必須

How comfortable do you feel discussing STI testing and sexual health with a healthcare provider?

スケール: 1 – 7
最小:Very uncomfortable最大:Very comfortable
Q05
マトリクス必須

How much does each of the following get in the way of you getting tested when you think you should?

6行 × 4列
  • Cost of testing
  • Concerns about privacy or confidentiality
  • Finding time or a convenient location
  • Embarrassment or stigma
  • Not having symptoms, so it doesn't feel urgent
  • ほか1件
列: Not a barrier · Minor barrier · Moderate barrier · Major barrier
Q06
評価スケール

If you've been tested before, how would you rate your most recent testing experience overall?

範囲: 1 – 5
最小:Very poor最大:Excellent
Q07
選択式

What would most encourage you to get tested more regularly (select all that apply)?

  • Lower cost or free testing
  • More privacy or anonymous options
  • Faster results
  • Easier scheduling or walk-in availability
  • A trusted at-home test option
  • Being asked/reminded by a provider
  • More open conversations with partners
Q08
AIインタビュー

Reconstruct the respondent's actual decision-making around their most recent testing experience (or lack of one): what prompted them to consider testing, what almost stopped them, and what specifically made it easy or hard. If they selected 'Never' been tested, gently probe what would need to change — cost, privacy, stigma, or access — for them to seriously consider it, without being judgmental. If they rated a barrier as 'major', ask for a concrete recent example of that barrier in action.

Q09
オピニオンスケール

How likely are you to recommend the testing service or provider you used to a friend?

スケール: 0 – 10
最小:Not at all likely最大:Extremely likely
Q10
選択式

What is your age range?

  • Under 18
  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55+
  • Prefer not to say
Q11
選択式

How do you describe your gender identity?

  • Woman
  • Man
  • Non-binary
  • Prefer not to say
Q12
選択式

How do you describe your sexual orientation?

  • Heterosexual/straight
  • Gay or lesbian
  • Bisexual
  • Prefer not to say
Q13
メッセージ

That's everything — thank you for your openness. Your answers will be combined with others to help improve access to sexual health testing and make the experience less stressful for everyone.

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Includes an AI follow-up interview that reconstructs the respondent's actual decision-making around their most recent testing experience, surfacing real reasons behind testing gaps that fixed-choice questions can't capture.
  • Pairs a matrix question quantifying specific barriers (cost, embarrassment, access, etc.) with opinion-scale items on comfort discussing testing with providers and likelihood to recommend the service.
  • Covers testing frequency, where people have been tested, and a rating of their most recent experience, plus age, gender identity, and sexual orientation breakouts for segmentation by clinics and public health teams.
  • Automated per-response quality scoring and auto-generated reports turn open-ended answers (including from an optional voice AI interview) into analyzable output without manual coding.

QuestionPro

Sexually transmitted disease survey questions + sample questionnaire template

This page presents sample STD survey questions and a questionnaire template, functioning more like a question-bank/guide than a ready-to-field survey bundled with reporting. It covers standard topics (testing history, knowledge, attitudes) using conventional question types, aimed at researchers building their own instrument.

優れている点

  • Broad sample question bank covering STD knowledge and testing topics
  • Backed by an established, well-known survey platform
  • Customizable questionnaire structure researchers can adapt

物足りない点

  • No adaptive AI follow-up to probe why respondents skip or delay testing — relies on static fixed-choice and scaled questions
  • No automated per-response quality scoring or auto-generated report output evident on the page
  • No transparent, published interview prompt methodology

Jotform

Sexually Transmitted Infection Report Form Template

This is a report/documentation form for recording STI cases, not a survey measuring testing experience, comfort, or barriers — a different use case (clinical/administrative reporting vs. attitudinal research). It's a static form builder template with no interview-style questioning or behavioral/attitude scales.

優れている点

  • Simple, quick-to-deploy form builder for capturing structured STI case data
  • Familiar drag-and-drop customization within the Jotform ecosystem

物足りない点

  • Not designed to measure testing frequency, comfort, or barriers — serves a reporting purpose rather than survey research
  • No adaptive AI follow-up or voice interview capability
  • No automated quality scoring or auto-generated analytical reports

よくあるご質問

「Sexual Health Testing Experience & Awareness Survey」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が13問含まれており、最初の設問は次のとおりです：「Thanks for taking a few minutes to share your experience with sexual health testing. Everything you share is confidentia…」・「In the last 12 months, how many times have you been tested for STIs?」・「Where have you gotten tested for STIs before (select all that apply)?」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、13問を約7分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

関連テンプレート

似たテーマのほかの調査もご覧ください。

すべて見る
Industry-Specific

LGBTQ+ Representation in Media Consumption Survey

Measures how LGBTQ+ audiences and allies encounter and judge queer representation in film, TV, and streaming — how often they see it, where, and whether it feels authentic — with an AI follow-up interview that digs into one specific portrayal that shaped their view. Built for media researchers, studios, and advocacy orgs.

テンプレートを見る
Industry-Specific

Contactless Health Screening Experience Survey

Captures how people experience contactless health screening kiosks or apps—ease of use, trust in accuracy, and privacy comfort—for clinics, workplaces, and events. An AI follow-up interview digs into the specific moment trust broke down or friction occurred, beyond a simple satisfaction score.

テンプレートを見る
Industry-Specific

Personal Health & Wellness Check-In Survey

A periodic self-assessment covering physical health, sleep, stress, activity levels, and emerging symptoms — used by clinics, employers, or wellness programs to spot concerns early. An AI follow-up interview digs into whatever symptom or concern the respondent flagged as most pressing, capturing duration, severity, and impact that a checkbox can't.

テンプレートを見る
Industry-Specific

Contactless Health Check Experience Survey

Captures how patients and employees experience contactless vital-sign screening — camera- or sensor-based checks for temperature, heart rate, or oxygen — covering ease of use, trust in accuracy, and privacy comfort. Built for clinics and workplaces piloting no-touch screening, with an AI follow-up that probes what drove doubt or confidence in the reading.

テンプレートを見る
Industry-Specific

Medical Examination & Check-Up Experience Survey

Captures how patients experience scheduling, wait times, communication, and results delivery during routine or diagnostic medical exams. Includes a best-worst trade-off to prioritize service improvements and an AI follow-up interview that reconstructs what actually happened during the visit — especially around how results were explained — rather than just a satisfaction score.

テンプレートを見る
Industry-Specific

Oral Health Habits & Dental Care Experience Survey

Measures everyday brushing and flossing habits, common symptoms like gum bleeding or sensitivity, satisfaction with dental visits, and the real barriers keeping people from care. Built for dental practices, oral care brands, and public health researchers. An AI follow-up interview digs into the specific symptom or barrier each respondent flagged, uncovering the actual reasons behind it instead of a generic checkbox.

テンプレートを見る