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What is your age in years?
   
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
Are you a Singaporean/Permanent Resident?
 
Yes
 
No
 
 
 
Have you given cancer and prevention a thought? Tick whichever ones apply
 
I have thought about it but not very seriously
 
I have thought about it and am trying to make some lifestyle changes
 
I will think about it if only I get it. Right now, who cares?
 
 
 
How afraid of cancer are you on a scale of 1 – 5, where 1 is not afraid at all and 5 is extremely afraid?
 
1
 
2
 
3
 
4
 
5
 
 
 
How many members in your family have been diagnosed with cancer? (Give in numerical values - 0,1,2...)