Parish Nurse Ministry
Exit this survey
Member Survey
To better meet the needs of the congregation we are asking for you to complete the following questions. There is no need to sign your name unless you want to do so. Thank you for your help.
1
. Health Status: please check if you if you have, or have had, any of the following
Health Status: please check if you if you have, or have had, any of the following
Heart Disease
High Blood Preasure
Diabetes
Physical Disability
Lung Disease
Stroke
Fibromyalgia
Cancer
Mental Illness
Arthritis
Neck/Back Pain
Other (please specify)
2
. What are your sources of health care information? Check all that apply.
What are your sources of health care information? Check all that apply.
Family Doctor
Medical Clinic (no designated MD)
Parish Nurse
Specialist (MD)
Internet
Health Magazines
Other (please specify)
3
. The following are health education topics that enhance our physical, spiritual, and educational health. Please mark the topics that you would like to learn more about.
The following are health education topics that enhance our physical, spiritual, and educational health. Please mark the topics that you would like to learn more about.
men's health issues
women's health issues
aging
stroke/hypertension
mental health
HIV/AIDS
heart disease
stress reduction
nursing home placement
coping with life changes
weight control
elder abuse
advance directives
grief and loss
arthritis
preretirement planning
domestic violence/abuse
substance abuse
maintaining health
retirement adjustment
Alzheimer's disease
parenting teens
chronic disease
nutrition
Other (please specify)
4
. I prefer to receive this information by:
I prefer to receive this information by:
written articles in Priority 1 (Redeemer's weekly newsletter)
guest speakers
printed educational materials
meet with the parish nurse to discuss health issues
5
. Your Name (optional)
Your Name (optional)
Powered by
SurveyMonkey
Create your own
free online survey
now!
Javascript is required for this site to function, please enable.