Question Title

* 1. Age group

Question Title

* 2. Which of the following options most closely aligns with your gender?

Question Title

* 3. Which session did you attend?

Question Title

* 4. Where in Circular Head do you live or which area is the closest to you?

Question Title

* 5. When was the last time you have a general check up with a GP?

Question Title

* 6. What are the main reasons you don't go the doctor regularly?

Question Title

* 7. Do you smoke?

Question Title

* 8. If you answered yes to smoking, how keen are you to give up?

Question Title

* 9. How many serves of vegetables (including fresh, frozen and tinned vegetables) do you usually eat each day?

Question Title

* 10. How many serves of fruit (including fresh, frozen and tinned fruit) do you usually eat each day?

Question Title

* 11. How many days of the week do you usually eat foods that are high in fat, salt, or sugar (such as deep-fried foods, hot chips, pies, pastries, chocolates, lollies, etc)?

Question Title

* 12. Why do you usually choose fast food instead of something you prepared yourself? (tick all that apply)

Question Title

* 13. How many times a week do you do 20 minutes or more of vigorous-intensity physical activity that makes you sweat or puff and pant (for example, heavy lifting, digging or jogging)? 
(Two x 10 minute sessions count as 20 minutes)

Question Title

* 14. How many times per week do you do 30 minutes or more of walking (for example, walking from place to place for exercise or recreation)?
(Three 10-minute sessions or two 15 minute sessions could as one 30 minute session)

Question Title

* 15. How many times per week do you do 30 minutes or more of other moderate-intensity physical activity that increases your heart rate or makes you breathe harder than normal (for example, carrying light loads, slow cycling)?

Question Title

* 16. How much of your total physical activity is part of your job? (includes travelling to and from work)

Question Title

* 17. a) Do you exercise outdoors using local parks or outdoor spaces? Please list any you use.

(eg: Godfrey’s Beach, Duck River walking track, Forest Recreation Ground)

Question Title

* 18. Why are you NOT more physically active?
Tick all that apply to you.

Question Title

* 19. How many hours do you spend at work in a typical day? (including travel)

Question Title

* 20. How many hours per day do you spend sitting?

Question Title

* 21. How many times per day do you interrupt your sitting by standing up, walking somewhere (ie to get a drink)

Question Title

* 22. Which of the following would you most likely use if it was in your local community or workplace?
Tick all that apply to you.

Question Title

* 23. When would you prefer health and wellbeing activities to occur?
Tick all that apply to you.

Question Title

* 24. How often would you attend a health and well being activity if it was offered?

Question Title

* 25. How far from work or home are you prepared to travel for free or low cost activities?

Question Title

* 26. How often do you drink alcohol?

Question Title

* 27. Do you have anything to add with regards to health and well being 

Question Title

* 28. Would you like to be contacted about your answers? If yes please leave you contact details below:

Question Title

* 29. Would you like to be added to a health and wellbeing data case to receive information about health and wellbeing events and activities.
If your answer is yes please add your contact details.

T