Personal Hygiene Survey
  • Name
  • Date of birth
  • Gender
  • Occupation
  • Rate the frequency of the following hygiene habits:
    (Never ) 1 - - 2 - - 3 - - 4 - - 5 (Frequently )
    Washing hands before food
    Washing hands after toilet
    Use hand sanitizers
    Wear washed clothes
    Walk outside without footwear
    Drink clean, safe drinking water
  • How regularly do you shower?
  • What type of soaps do you use?
  • How regularly do you brush your teeth?
  • How regularly do you floss?
  • When do you wash your hands during the day? Check all that apply.
  • How often do you clean the house?
  • How often do you dispose of trash ?

That's all, folks!

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