Male Questionnaire
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This section deals with various anemias.


Have you had confirmed Iron Deficiency Anemia?
  • Don't know
  • No - ruled out within last 3 months
  • Past episode(s) now fully resolved
  • Current minor problem
  • Current major problem


If Iron Deficiency Anemia is a recurring problem, how difficult has it been to resolve when adequate iron was being taken?
  • Not applicable / don't know
  • Taking additional iron easily resolves the anemia
  • Iron is required daily to prevent anemia
  • Large amounts of iron will resolve the problem
  • Even large amounts of iron help only a little


Have you been diagnosed with Pernicious Anemia? This is caused by vitamin B12 deficiency and is a type of Megaloblastic Anemia.
  • Don't know
  • No, I definitely do not have it
  • In the past, not taking B12 now
  • Current problem, taking B12 orally
  • Current problem, taking B12 by injection


Do you have the Sickle Cell Trait or Sickle Cell Anemia / Disease?
  • Don't know
  • No, tested negative
  • Sickle cell trait only
  • Sickle cell disease


Have you been diagnosed with a Hemolytic Anemia?
  • Don't know
  • No, that has been ruled out
  • Yes, but in the past only
  • Current minor / moderate problem
  • Current serious / severe problem


Have you been diagnosed with Thalassemia?
  • Don't know
  • No, it has been ruled out
  • Yes, transfusion(s) not necessary
  • Yes, needed transfusion(s) but not regularly
  • Yes, must have regular transfusions