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OnTrack - Who5 Wellbeing Survey
*
1.
Which Code do you belong to? (Select the one where you race or work the most)*
(Required.)
New Zealand Greyhound Racing
New Zealand Harness Racing
New Zealand Thoroughbred Racing
Other
*
2.
Please select the region you are based in?*
(Required.)
Northland
Auckland
Waikato
Wellington
Otago
South
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3.
In the last two weeks, I have felt calm and relaxed.
(Required.)
All of the time
Most of the time
More than half the time
Less than half the time
Some of the time
At no time
*
4.
In the last two weeks, I have felt cheerful in good spirits.
(Required.)
All of the time
Most of the time
More than half the time
Less than half of the time
Some of the time
At no time
*
5.
In the last two weeks, I have felt active and vigorous.
(Required.)
All of the time
Most of the time
More than half the time
Less than half the time
Some of the time
At no time
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6.
In the last two weeks, I woke up feeling fresh and rested.
(Required.)
All of the time
Most of the time
More than half of the time
Less than half of the time
Some of the time
At no time
*
7.
In the last two weeks, my daily life has been filled with things that interest me.
(Required.)
All of the time
Most of the time
More than half of the time
Less than half of the time
Some of the time
At no time
*
8.
I would like to talk with someone?
(Required.)
Yes
No
9.
First Name: (If you wish to be contacted)
10.
Last Name: (If you wish to be contacted)
11.
Phone number: (If you wish to be contacted)
12.
Email address: (If you wish to be contacted)
