Pre-Event Survey
Total Wellness
Summit
March 28, 2019

Question Title

* 1. Contact Information

Name

Company

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. My gender is:

Female

Male

Other

Question Title

* 3. I identify myself as:

White

Black

Hispanic

Asian

Other

Question Title

* 4. Which organizations are you familiar with? Check all that apply.

Follow The Leader Foundation, Inc.

Los Angeles Department of Mental Health

California Mental Health Services Authority

National Alliance on Mental Illness

JVS Socal- Jobs. Vision. Success.

None of the Above

Question Title

* 5. How important is Mental Health Wellness to you?

Extremely important

Very important

Somewhat important

Not so important

Not at all important

Question Title

* 6. How familiar are you with prevention and intervention?

Extremely familiar

Very familiar

Somewhat familiar

Not so familiar

Not at all familiar

Question Title

* 7. How likely are you take connect individuals to supports for mental wellness?

Very likely

Likely

Neither likely nor unlikely

Unlikely

Very unlikely

Question Title

* 8. Are you willing to get support in designing a Total Wellness plan for you by experts in your community?

Yes

Pre-Event SurveyTotal Wellness SummitMarch 28, 2019

Question Title

* 1. Contact Information

Question Title

* 2. My gender is:

Question Title

* 3. I identify myself as:

Question Title

* 4. Which organizations are you familiar with? Check all that apply.

Question Title

* 5. How important is Mental Health Wellness to you?

Question Title

* 6. How familiar are you with prevention and intervention?

Question Title

* 7. How likely are you take connect individuals to supports for mental wellness?

Question Title

* 8. Are you willing to get support in designing a Total Wellness plan for you by experts in your community?

Pre-Event Survey
Total Wellness
Summit
March 28, 2019