Made in Surveys - your online quantitative research & fieldwork partner since 2001

Why do I have access to this questionnaire?

Our company, MIS Group, regularly conducts studies for scientific research, particularly in the field of Health.

To minimise the number of people we contact for participation in Health-related studies, we have developed this profile questionnaire for members of our site (the "Panellists").

The sole purpose of this questionnaire is to better qualify your profile so that we can invite you only to studies relevant to you (targeting people with your profile, specific conditions, etc.).

What is the legal framework for processing my answers?

MIS Group is responsible for processing the responses collected through this questionnaire.

Participation in this questionnaire is entirely voluntary, especially if you do not wish to be contacted for Health-related studies.

The legal basis for processing these responses is Consent.

Who will have access to my answers?

Our company, MIS Group, and more specifically its authorised employees who have received the necessary training in the protection of personal data, are the sole recipients of the answers collected from this questionnaire.

Your answers will only be used to qualify your profile (pre-targeting). Under no circumstances will public or private bodies requesting us to carry out studies in the health field have access to the answers you record in this profile questionnaire.

How are the confidentiality and security of my answers guaranteed?

Specific measures have been taken to guarantee the confidentiality and security of your answers to this questionnaire. Your answers will be stored in a secure file:

On a computer server located in France;
At an HDS-certified hosting provider (Health Data Hosting): OVH.

OVH is therefore acting as a sub-contractor to host the responses collected.

Furthermore, no link will be established by MIS Group between your answers to this questionnaire and any identification data that may be directly personal (such as the information in your "Panellist" account: your first and last names, your email address, etc.):

Your answers will be stored pseudonymously, with your "Identifier" (the sequential number allocated to you when you register on our site) as your only identifying data;
Your answers (with your login) and the information in your "Panellist" account will be stored separately, in separate files;
No action will be taken to re-identify you on the basis of your identifier in order to establish a link between your answers and your identity.

What are my rights once my answers have been recorded?

In accordance with current regulations on the protection of personal data, you have the right to access, rectify and delete your answers.

If you wish to exercise your rights with MIS Group, please contact our Data Protection Officer at the following address: dpo@misgroup.io

If you believe that your rights have not been respected after contacting us, you may file a complaint with the Information Commissioner's Office (ICO).

I have read the Legal Notices related to the "Health" profile questionnaire, and I agree to complete it. ✅

I refuse to complete the questionnaire ❌

Do you suffer from any of the following medical conditions?

Eye, ear, nose and throat disorders

Painful conditions or diseases of the bones/joints/muscles

Dental conditions

Allergies

Cancer

Diabetes

Skin disease

Heart/blood diseases

Digestive diseases

Immunological diseases

Neurological/cerebral diseases

Respiratory diseases

Weight problems

Women's health

Men's health

Mental health and behaviour

Sexual health

Learning and cognitive disorders (ADHD, ADD, etc.)

Sleep disorders

Post-traumatic disorder (loss of limb, accident, war, surgery, etc.)

None of the above

I do not wish to answer

Which of the following medical devices do you use?

Orthodontic appliances

Restraint systems

Crutches

Oxygen cylinders

Cane

Walker

Denture

Manual wheelchair

Motorised wheelchair

Multisport chair

Verticalizer

Lift chair

Raised Toilet seat

Angled and enlarged cutlery

Anti-slip lenses

Bath seat

Sock or stocking aid

Grab rail

Transfer turner/turning aid

Righting bar

Adapted car

Adapted keyboards, adapted mice, ergonomic office chairs, forearm supports, video magnifiers, software, speech synthesisers, voice dictation, etc.

Medical bed

Nicotine gum

Nicotine patches

Retainers

Inhalers

Adrenaline injector

Insulin pen injector

Blood glucose meter

Contact lenses

Glasses with corrective lenses

Reading glasses

Nebulisers

Prosthesis

Hearing aids

Hip prosthesis

Knee prosthesis

Dental prosthesis

Stents

Pacemakers

Other medical equipment, please specify :

None of the above

I do not wish to answer

Which of the following eye, nose, ear or throat problems are you suffering from or have suffered from?

Tinnitus

Impaired vision

Astigmatism

Cataract

Blindness

Conjunctivitis

Vision correction - laser treatment

Macular degeneration

Glaucoma

Hyperopia

Myopia

Nasal obstruction

Otitis

Hearing loss

Presbyopia

Snoring

Dry eye syndrome

Colour blindness

Hearing impairment of any kind

Other ear, nose or throat conditions, please specify

None of these disorders

I do not wish to answer

You answered that you have a visual disability. Which one is it?

Mild impairment

Moderate impairment

Severe impairment

Profound impairment

Almost total impairment

Total impairment

I do not wish to answer

In your daily life, what technical aids do you use?

Braille (reading method for the visually impaired or blind)

Non-optical visual aids (memory telephones, large keys, line guides for cheques, etc.)

Optical vision aids (magnifiers, telescopic systems)

Electronic distance vision aids (helmets with an integrated video camera, displaying the image in front of the patient's eyes)

Coloured filters (to enhance contrast vision).

Speech synthesis: Android talkback or iOS voiceover

A white cane

A guide dog

Other, please specify

I do not wish to answer

You answered that you have a hearing disability. Which one is it?

Mild hearing loss: speech is difficult to understand in a noisy environment and soft sounds are not perceived. Tinnitus (continuous ringing or whistling) and hyperacusis (intolerance to certain frequencies and noises) may occur.

Moderate hearing loss: soft and moderately loud sounds are not audible and speech is very difficult to understand in the presence of ambient noise.

Severe hearing loss: group conversations are laborious and you have to speak loudly to be heard. These exchanges are a source of stress and cognitive fatigue for the hearing impaired person.

Profound hearing loss: communication is impossible without hearing aids, and only a few very loud sounds are perceived by the hearing impaired person.

I do not wish to answer

What technical aids do you use in your daily life?

BTE and ITE hearing aids

Cochlear implant

Lip reading

British sign language

Speech therapy

Audio induction loop

Personal amplifier

Transmitter/receiver cases

Deaf / Hearing communication platform

Speech synthesis

Subtitles

Android and IOS applications

Velotype

Other, please specify

I do not wish to answer

From the following list, which bone/joint/muscle pains or disorders do you suffer from or have you suffered from?

Amputation

Arthritis

Rheumatoid arthritis

Osteoarthritis

Lower back pain

Muscle pain

Neuropathic pain

Persistent or chronic pain

Muscular dystrophy

Fibromyalgia

Gout

Joint inflammation

Lupus

Headaches

Migraines

Myasthenia gravis

Osteoporosis

Psoriatic arthritis

Multiple sclerosis

Other bone/joint/muscle pain or disease, please specify

None of these answers

I do not wish to answer

Which of the following dental conditions are you suffering from or have suffered from?

Abscess

Mouth ulcers

Bruxism

Cavities

Tooth loss

Gingivitis

Oral thrush

Periodontitis

Other dental condition, please specify

None of these answers

I do not wish to answer

Which of the following allergies do you suffer from or have suffered from?

Food allergies

Latex allergy

Allergies to cosmetics

Plant allergies (poison ivy, etc.)

Drug allergies

Seasonal allergies (pollen, etc.)

Insect bites

Other allergies, please specify

None of these answers

I do not wish to answer

Which of the following forms of cancer are you suffering from or have suffered from?

Ovarian cancer

Uterine cancer

Prostate cancer

Bladder cancer

Bone cancer

Brain cancer

Cervical cancer

Colon cancer

Liver cancer

Lung cancer

Kidney cancer

Breast cancer

Leukaemia

Non-Hodgkin's lymphoma

Hodgkin's disease

Melanoma

Multiple myeloma

Other cancer, please specify

None of these answers

I do not wish to answer

Which of the following types of diabetes do you have or have had?

I

II

I do not wish to answer

Do you use insulin? If so, what type of insulin?

By mouth (tablets)

By injection: via an insulin pump

By injection: via a NON-connected insulin pen

By injection: via a connected insulin pen

Both injectable and oral

No

I do not wish to answer

Which of the following dermatological conditions do you suffer from or have suffered from?

Acne

Amyloidosis

Atopy

Carcinoma

Couperose

Dermatosclerosis

Eczema

Skin rash (dermatitis)

Moles/Warts

Mycoses

Dry skin

Psoriasis

Age spots

Other skin condition, specify

None of these answers

I do not wish to answer

Which of the following heart/blood disorders are you suffering from or have suffered from?

Stroke/TIA

Anemia or other blood disorders

Angina pectoris

Heart attack/myocardial infarction

Pulmonary embolism

Atrial fibrillation

Congestive heart failure (CHF)

Haemophilia

Hepatitis A

Hepatitis B

Hepatitis C

Hyperlipidemia

Hypoglycaemia

Low blood pressure

Heart disease

Circulatory problems in the legs

Abnormal heart rhythm

High cholesterol

High triglyceride levels

High blood pressure/hypertension

Thrombosis

Deep Vein Thrombosis

Recent blood transfusion

Varicose veins

Other heart/blood disease, specify

None of these answers

I do not wish to answer

Which of the following digestive disorders do you suffer from or have you suffered from?

Inflammatory bowel disease (IBD)

Gallstones

Kidney stones

Colitis

Constipation (persistent or chronic)

Diarrhoea (persistent or chronic)

Gas/bloating

Bowel incontinence

Urinary incontinence/bladder control

Urinary tract infection (UTI)

Crohn's disease

Nausea

Pyrosis/GERD

Irritable bowel syndrome (IBS)

Stomach ulcers

Intestinal ulcers

Overactive bladder

Other gastrointestinal condition, specify

None of these answers

I do not wish to answer

Which of the following immunological conditions do you suffer from or have you suffered from?

Primary immunodeficiency (PI)

Lupus

HIV/AIDS

Other immunological disease, specify

No

I do not wish to answer

Which of the following neurological/brain disorders do you suffer from or have suffered from?

Cerebrovascular accident (CVA)

Seizure (not epilepsy-related)

Dementia

Alzheimer's disease

Parkinson's disease

Headaches

Migraines

Multiple sclerosis

Essential tremor

Epilepsy

Other brain/neurological condition, specify

None of these answers

I do not wish to answer

Which of the following respiratory problems do you suffer from or have you suffered from?

Asthma

COPD (chronic obstructive pulmonary disease)

Bronchitis (chronic)

Emphysema

Cystic Fibrosis

Pulmonary vascular disease

Chronic respiratory diseases

Chronic sinusitis

Other respiratory disorders, please specify

None of these answers

I do not wish to answer

Which of the following women's health problems do you suffer from or have suffered from?

Loss of libido

No menses (amenorrhoea)

Vaginal candidiasis

Prenatal supplement

Menstrual cramps (dysmenorrhoea)

Female sexual dysfunction

Endometriosis

Uterine fibroids

Vaginal infections

Menopause

Osteoporosis

Painful ovulation (Mittelschermz)

Abnormal uterine bleeding

Infertility

Pelvic inflammatory disease

Premenstrual syndrome

Hormone replacement therapy

Premenstrual dysphoric disorder

Female sterilisation

Other female health problem, please specify

None of these answers

I do not wish to answer

Which of the following men's health problems do you suffer from or have suffered from?

Loss of libido

Erectile dysfunction (impotence)

Sexual dysfunction

Low testosterone levels

Male infertility

Premature ejaculation (PE)

Testicular disorder

Penis disorder

Vasectomy

Other male conditions, please specify

None of these answers

I do not wish to answer

Which of the following mental/behavioural disorders do you suffer from or have suffered from?

Anxiety

Stress-related anxiety

Bipolarity (manic-depressive disorder)

Anxiety attacks

Dementia

Persistent depressive disorder (dysthymia)

Seasonal affective disorder (SAD)

Depressive disorder (depression)

Alzheimer's disease

Phobias

Schizophrenia

Paranoia

Post-traumatic stress disorder (PTSD)

Addictive disorder

Eating disorders

Social anxiety disorder

Attention deficit disorder (ADHD, ADD)

Obsessive compulsive disorder (OCD)

Psychiatric disorders of any kind

Other mental and behavioural health problems, please specify

None of these answers

I do not wish to answer

Which of the following sexual health conditions do you suffer from or have suffered from?

Loss of libido

Sexual dysfunction

Herpes

Genital herpes

HIV/AIDS

Erectile dysfunction (impotence)

Sexually transmitted diseases (STDs) of any kind

Human papillomavirus (HPV)

Infertility

Other sexual health problem, please specify

None of these answers

I do not wish to answer

Which of the following learning and cognitive disabilities affect you or apply to you?

ADHD or ADD (Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder)

Autism, autistic spectrum disorders (Asperger's syndrome, pervasive developmental disorder)

Intellectual development disorders (IDD)

Dyslexia

Dysorthography

Dyscalculia

Dyspraxia (DCD)

Dysphasia

Intellectual disability

Speech, language and communication disorders

Tourette's disorder and other tics

Other cognitive and learning disabilities, please specify

None of these disorders

I do not wish to answer

In your daily life, what technical aids do you use?

The tutorial function, which uses the computer and its software as a kind of repeater, with batteries of systematic exercises.

The procedural function: IT is a vehicle for reflection and offers specific support to encourage reasoning and even to organise thought.

The communication function: encompasses the ability to consult and exchange resources.

The supplementary or prosthetic function: the computer becomes a tool capable of directly or indirectly replacing a deficient function 'doing when you can't.'

The augmentative function facilitates and optimises certain abilities that children already have, but to a lesser extent. In this case, the computer makes it possible to improve the efficiency of the pupils' productions and therefore to increase their performance, which without this aid would be less operational.

Speech synthesis

Spellcheckers

Voice recognition or voice dictation

Pulsed light lamp

Keyboard with dyslexia-friendly font

Digital pen

Reader and translator pen

Other, please specify

None of these

I do not wish to answer

Which of the following sleep disorders do you suffer from or have you suffered from?

Sleep apnoea

Insomnia

Narcolepsy

Sleepwalking

Restless legs syndrome

Other sleep disorder, specify

None of these answers

I do not wish to answer

Do you receive any of the following benefits?

Personal Independence Payment (PIP)

Attendance Allowance

Disability Living Allowance (DLA)

Carer’s Allowance

Employment and Support Allowance (ESA)

Blue Badge Scheme

Disabled Students’ Allowance (DSA)

Access to Work grant

None of these

I do not wish to answer

You have stated that you receive Carer’s Allowance. What level of support do you provide?

High level of support (Full-time care, more than 35 hours per week)

Moderate level of support (Between 20-35 hours per week)

Low level of support (Less than 20 hours per week)

I do not wish to answer

Do you have official recognition of disability or reduced autonomy?

Yes

No

My application is in progress

I do not wish to answer

Profile questionnaire « Health »