No Man Left Behind Survey

Welcome to the No Man Left Behind survey. Please take a brief moment to share your suggestions and thoughts. Your feedback is important to us, and all responses are 100% anonymous.

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* 1. How often would you like the group to meet?

Once a month

Every other month

Quarterly (every 3 months)

Other (please specify)

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* 2. How should we meet?

In-person

Online

Both

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* 3. Best days/times for meetings:

Weekdays: (evenings)

Weekends: (mornings/afternoons)

Other (please specify)

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* 4. Rank these topics from most important to least important (1 = most important, 4 = least important):

	1	2	3	4	5
Physical health (exercise, nutrition)	Physical health (exercise, nutrition) 1	Physical health (exercise, nutrition) 2	Physical health (exercise, nutrition) 3	Physical health (exercise, nutrition) 4	Physical health (exercise, nutrition) 5
Mental health (stress, mindfulness)	Mental health (stress, mindfulness) 1	Mental health (stress, mindfulness) 2	Mental health (stress, mindfulness) 3	Mental health (stress, mindfulness) 4	Mental health (stress, mindfulness) 5
Preventive care (screenings, check-ups)	Preventive care (screenings, check-ups) 1	Preventive care (screenings, check-ups) 2	Preventive care (screenings, check-ups) 3	Preventive care (screenings, check-ups) 4	Preventive care (screenings, check-ups) 5
Lifestyle (work-life balance, hobbies)	Lifestyle (work-life balance, hobbies) 1	Lifestyle (work-life balance, hobbies) 2	Lifestyle (work-life balance, hobbies) 3	Lifestyle (work-life balance, hobbies) 4	Lifestyle (work-life balance, hobbies) 5
Volunteerism and Community Involvement	Volunteerism and Community Involvement 1	Volunteerism and Community Involvement 2	Volunteerism and Community Involvement 3	Volunteerism and Community Involvement 4	Volunteerism and Community Involvement 5

Other (please specify)

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* 5. Would you like group activities (e.g., walks, sports)?

Yes

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* 6. How important is confidentiality - keeping things private?

Very important

Somewhat important

Not important

Very important

Somewhat important

Not important

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* 7. (Optional) Age range:

Under 30

30-45

46-59

60+

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* 8. Are you interested in joining SEMRHI's No Man Left Behind Initiative?

Yes