NEED ENERGY quick questionnaire
Exit this survey
1. NEED ENERGY quick questionnaire; www.michellecederberg.com
1
. How do you think your life would change if you had more ENERGY?
How do you think your life would change if you had more ENERGY?
2
. If you have difficulty prioritizing your health and self-care, what are three major reasons why?
If you have difficulty prioritizing your health and self-care, what are three major reasons why?
3
. What would help you experience greater success with exercise, healthy eating, and good lifestyle choices?
What would help you experience greater success with exercise, healthy eating, and good lifestyle choices?
4
. What is your gender?
What is your gender?
M
F
5
. What is your age range?
What is your age range?
<20
20-29
30-39
40-49
50-59
60+
6
. What is your current work situation?
What is your current work situation?
Full-time
Part-time
Stay-at-home-parent
Other
Other (please specify)
Thank you for taking the time to complete this questionnaire. Please know that information will be kept confidential. Should I wish to contact you to learn more about your story, may I do so?
If YES, please complete contact information below.
7
. Your contact information:
Your contact information:
Full name
Email address
Where do you live?
Powered by
SurveyMonkey
Create your own
free online survey
now!
Javascript is required for this site to function, please enable.