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HCHD Employee Health & Interest Survey

Program & Topic Interests

BALANCE
This survey is VOLUNTARY and will be submitted ANONYMOUSLY (your identity cannot be discovered, nor are individual responses shared with your employer; data is collected only in aggregate). You are not required to provide this information. You may choose to skip any question.

Survey questions adapted from: Centers for Disease Control and Prevention. Work@Health. Compiled by ASHLIN Management Group, 2015.
1.How would you like to learn about health and wellness information? (Select all that apply)
2.Using the scale below, please rate how interested you are in each wellness topic. The more specific information we receive, the better HCHD can tailor the wellness program to fit your wants and needs.
Extremely Interested
Slightly Interested
Not Interested
Acupuncture
Aging
Back Pain/Injury Prevention
Depression
Diabetes
Environmental Health
Ergonomics
Financial Wellness
Fitness Classes
Healthy Cooking
Homeopathy
Meditation
Nutrition Services
Seated Massage
Sleep
Smoking Cessation
Stress Management
Weight Management
3.What day and time would you be most likely to participate in a wellness program? (Select all that apply)
4.If offered, what types of screenings would you participate in? (Select all that apply)
5.If offered, what types of fitness activities would you participate in? (Select all that apply)
6.Are you aware of the onsite shower and changing room (both men and women)? 
7.Please feel free to share any additional comments or ideas you have regarding the Balance wellness program.
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