Wellness Program Survey

Northland Health Centers are glad you chose 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 found 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. Please report your beginning and ending weight.  

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* 7. What is your email address?

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* 8. Which of the following healthy changes did you experience as a result of the Wellness Program? (mark all that apply to you)

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* 9. Did you enjoy participating in the Wellness Program?

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* 10. Would you like to participate in this type of health challenge again?

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* 11. What did you like MOST about the Wellness Program?

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* 12. What did you like LEAST about the Wellness Program?

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* 13. What changes can we make to improve the Wellness Program?

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