Wellness Program Survey

Northland Health Centers are excited you have chosen to be part of the Wellness Program!
This challenge was designed to encourage overall wellness, consistent physical activity, and healthy diet choices. We hope you find this to be a fun experience for developing positive lifestyle changes.

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* 1. What is your name?

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* 2. Which Northland Health Center are you competing at?

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* 3. Please report on your MINUTES of exercise each day.
Be sure to report MINUTES, not POINTS. 
If you did not exercise on a specific day, enter a zero.

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* 4. Please report on your SERVINGS of fruits and vegetables consumed each day.
Be sure to report SERVINGS, not POINTS. 
If you did not eat fruits or vegetables on a specific day, enter a zero.

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* 5. Please report on your SERVINGS of sugary treats consumed each day.
Be sure to report SERVINGS, not POINTS. 
If you did not consumer sugary treats on a specific day, enter a zero.

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* 6. What is your current weight in pounds?

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* 7. Do you have any suggestions or input to help improve the Wellness Program?

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* 8. What is your email address?

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