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Tai Chi/Qigong/Meditation Class Survey
1.
Do you know anything about the following? Please check all that apply.
Tai Chi
Qigong
Meditation
2.
If so, what is your experience with it?
3.
What types of lessons would you most be interested in? Please check all that apply.
Tai Chi for Arthritis
Tai Chi for Arthritis and Falls Prevention
Tai Chi for Heart Conditions
Tai Chi for Diabetes
Tai Chi for Osteoporosis
Qigong
Meditation
4.
Which days of the week would you be available for lessons? Please check all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
5.
Which times of day would you be available? Please check all that apply.
Mid to late morning
Early afternoon
Late afternoon
Early evening
Late evening
6.
What do you hope to accomplish by taking classes?
Stress reduction
Improved balance
Improved strength and flexibility
Improved health
Decreased pain
Improved immune systen
Increased energy
Lower blood pressure
Help with diabetes
Increased relaxation
Improve focus and mental clarity
Other, please enter below
7.
Which types of lessons would you be interested in?
Virtual (Zoom)
In-person
Either Zoom or in-person
8.
Name
9.
Email address
10.
Cell phone