Wellness and Performance Member Survey
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1. 2010 Bellin Wellness Member Survey
1
. Gender
Gender
Male
Female
2
. Age in years?
14 - 19
20 - 29
30 - 45
46 - 59
60 +
Select the response that describes you.
*
Age in years? Select the response that describes you. 14 - 19
Select the response that describes you. 20 - 29
Select the response that describes you. 30 - 45
Select the response that describes you. 46 - 59
Select the response that describes you. 60 +
3
. How long have you been a member?
How long have you been a member?
0-3 months
4-6 months
6 months - 2 years
3 - 5 years
6 - 9 years
10+ years
4
. What location do you use primarily?
What location do you use primarily?
Bellevue
West Side
Use both sites equally
5
. Is our staff friendly?
Very Satisfied
Satisfied
Somewhat Satisified
Unsatisfied
Needs Improvement
Select the response that describes your overall impression.
*
Is our staff friendly? Select the response that describes your overall impression. Very Satisfied
Select the response that describes your overall impression. Satisfied
Select the response that describes your overall impression. Somewhat Satisified
Select the response that describes your overall impression. Unsatisfied
Select the response that describes your overall impression. Needs Improvement
6
. My Medical/Health condition was considered prior to/during orientation process?
very satisfied
satisfied
somewhat satisfied
needs improvement
Select the response that describes your overall impression.
*
My Medical/Health condition was considered prior to/during orientation process? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. needs improvement
7
. How would you rate your orientation to the facility?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
How would you rate your orientation to the facility? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
8
. Is it easy for you to get assistance from a wellness center employee when needed?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
Is it easy for you to get assistance from a wellness center employee when needed? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
9
. Are the programs and services offered meeting or exceeding your expectations?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
Are the programs and services offered meeting or exceeding your expectations? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
10
. Are the facilities hours convenient?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
Are the facilities hours convenient? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
11
. Are your concerns resolved timely and to your level of satisfaction?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
Are your concerns resolved timely and to your level of satisfaction? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
12
. Are the facilities (i.e. group fitness, locker rooms, etc) kept clean?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
Are the facilities (i.e. group fitness, locker rooms, etc) kept clean? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
13
. How satisfied are you with the equipment?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
How satisfied are you with the equipment? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
14
. How often do you visit the XL athletic performance?
Daily
3-5x/week
1-2x/week
seldom
Select the response which best describes how often you participate.
*
How often do you visit the XL athletic performance? Select the response which best describes how often you participate. Daily
Select the response which best describes how often you participate. 3-5x/week
Select the response which best describes how often you participate. 1-2x/week
Select the response which best describes how often you participate. seldom
15
. How often do you use the cardiovascular equipment?
daily
3-5x/week
1-2x/week
seldom
Select the response which best describes how often you participate.
*
How often do you use the cardiovascular equipment? Select the response which best describes how often you participate. daily
Select the response which best describes how often you participate. 3-5x/week
Select the response which best describes how often you participate. 1-2x/week
Select the response which best describes how often you participate. seldom
16
. How often do you use the strength equipment?
daily
3-5x/week
1-2x/week
seldom
Select the response which best describes how often you participate.
*
How often do you use the strength equipment? Select the response which best describes how often you participate. daily
Select the response which best describes how often you participate. 3-5x/week
Select the response which best describes how often you participate. 1-2x/week
Select the response which best describes how often you participate. seldom
17
. How often do you use the group fitness room for non-class activities such as stretching, core work, or other personal wellness activites?
daily
3-5x/week
1-2x/week
seldom
Select the response which best describes how often you participate.
*
How often do you use the group fitness room for non-class activities such as stretching, core work, or other personal wellness activites? Select the response which best describes how often you participate. daily
Select the response which best describes how often you participate. 3-5x/week
Select the response which best describes how often you participate. 1-2x/week
Select the response which best describes how often you participate. seldom
18
. How often do you use the childcare?
daily
3-5x/week
1-2x/week
seldom
Select the response which best describes how often you participate.
*
How often do you use the childcare? Select the response which best describes how often you participate. daily
Select the response which best describes how often you participate. 3-5x/week
Select the response which best describes how often you participate. 1-2x/week
Select the response which best describes how often you participate. seldom
19
. Are you satisfied with member communications (i.e. flyer's, schedules, newsletter, etc)?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
Are you satisfied with member communications (i.e. flyer's, schedules, newsletter, etc)? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
20
. How would you rate your overall experience?
very satisfied
satisfied
somewhat satisfied
unsatisfied
needs improvement
Select the response that describes your overall impression.
*
How would you rate your overall experience? Select the response that describes your overall impression. very satisfied
Select the response that describes your overall impression. satisfied
Select the response that describes your overall impression. somewhat satisfied
Select the response that describes your overall impression. unsatisfied
Select the response that describes your overall impression. needs improvement
21
. Have you or would you recommend this center to others?
Have you or would you recommend this center to others?
YES
NO
22
. If a staff member has provided you with exceptional service, please write staff member's name below and indicate the service provided.
If a staff member has provided you with exceptional service, please write staff member's name below and indicate the service provided.
23
. What do you like most about the Bellin Health Wellness and Performance Center?
What do you like most about the Bellin Health Wellness and Performance Center?
Programs That Help Me Manage My Health Conditions
Customer Service/Staff
Group Fitness Classes
Personal Training
Cleanliness
Social Interaction
Hours
24
. What would enhance your membership experience?
What would enhance your membership experience?
Online Registration for Classes and Memberships.
Equipment Changes/Additions.
Trainer available on floor for assistance.
Member benefits and specials.
Wellness/Fitness incentives for members.
Other (please specify)
25
. Please add your comments. If you would like to be contacted please enter your name and contact information here.
Please add your comments. If you would like to be contacted please enter your name and contact information here.
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