Herpes Survey

Survey

View the experiences of others here.

Take our Survey

Let your voice be heard!
Submit the survey and include YOUR experiences
in the information box to see it posted online.


Your Name (required)

Your Email (required)

Subject

[your-subject]

Gender
MaleFemale


Age


Marital Status
MarriedSingle


Number of Sexual Partners


Transmission Prevention
CondomsFoamsAbstinenceNone


At what Age did you contract Herpes?


Are you a Herpes carrier?
YesNo


What type of Herpes do you have?
Type 1Type 2


What diagnostic test was used to determine the type of Herpes?
Living Cell Culture(PAP) smearOtherNone


Do you have any of the following herpes symptoms during lesion formation?
sharp painsmuscle achesswollen lymph glandsheadachesfever and general malaise


What treatments do you use for Herpes?
Prescription medicationOver-the-counter medicationPsychotherapyDiet/NutritionVitamins/HerbsStress ReductionNone


How frequently do you have outbreak recurrences?
1 time per 1-5 years4-7 times per year1-2 times per month


Average duration of Herpes recurrences
1-3 days4-7 days8-10 daysmore than 10 days


What do you feel causes your herpes outbreaks?
Stress at homeStress at workSunburnOther health problemsPoor nutritionVigorous sexual intercourseMenstrual cycleOver-tirednessDon't know causes


How has herpes affected your pregnancy plans?
0 (Not at all)1234 (A great deal)


Highest education level
Grade schoolSome high schoolHigh school graduateSome collegeCollege graduateSome graduate schoolGraduate degreeProfessional degree


Do you have a herpes experience you’d like share with others?


Regional Information:

City


State/Province


Country


Thank you for your participation.


All rights reserved.
Herpes.com reserves the right to determine which articles may be published.
All articles will become the exclusive property of herpes.com.

No part of these articles may be copied or reproduced in any way shape or
form by any mechanical, photographic, or electronic process, nor may it be
stored in a retrieval system, transmitted, or otherwise copied for public
or private use without the written permission of Herpes.com


Red Marine Algae | Buy 2 get 1 FREE VIR-L-Lysine | Buy 2 get 1 FREE
  • Top 10 Herpes Facts

    Sex Health Guru Video Tip brought to you by Alice W. Kp M.D. John Hopkins Hospital, Watch the Video

  • Featured Article

    The Truth about HSV-1 and HSV-2 American Social Health Association (ASHA), read the Article

  • Other Infections

    Do you also think you may have been exposed to another STD? Find help now. www.stdsite.com