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Be Well would like to know the current status of your wellness and physical activities to improve our Be Well Employee Wellness Program. Your honest answers will help Be Well evaluate program goals and objectives. Your name and contact information are NOT submitted with this survey: your responses are anonymous.

At the end of the survey you will be provided a web link to a page that will allow you to enter your name and email.  This is the means by which we will be recording your participation in the Be Well Rewards program requirement. 

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* 1. In an average week, how many days do you participate in 30 minutes of physical activity that cause increases in breathing or heart rate? (check only one)

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* 2. Do you currently use any type of nicotine product? (check all) If not, skip to question 5.

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* 3. How interested are you in quitting nicotine? (check only one). 

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* 4. How often do you participate in meditation or stress reducing activities?

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* 5. Based on the chart (click here) are you overweight for your height?

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* 6. If you are overweight, in the past 12 months have you been successful in reducing your weight?

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* 7. In which of the following categories would you place yourself?

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* 8. If you could receive information for five of the health topics listed below, which would you select? (check up to 5)

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* 9. If it was a topic of interest to you, which format would be the most appealing to you? (pick up to two)

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* 10. How long would you like a wellness activity to last? (not physical activity)

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* 11. Would you participate in any of the following wellness activities if available? (check all that apply)

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* 12. What is the best way for your worksite to help employees to be physically active?

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* 13. Where do you obtain most of your preventive health care screenings (Cholesterol, Blood Pressure, Body Mass Index, Blood Sugar levels)?

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* 14. Where are you most likely to participate in wellness (not just physical) activities? (check all that apply)

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* 15. Are there any barriers that prevent you from participating in wellness activities? (Check all that apply.)

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* 16. What do you see as the biggest challenge to you meeting your health goals, not related to your worksite?

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* 17. How would you prefer to receive information about Be Well events? (Check up to two answers.)

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* 18. Please rate how helpful the Be Well program has been in helping you reach your wellness goals?

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* 19. Please rate Be Well Team on the following criteria:

  Excellent Very Good Average Below Average Not Applicable
Professionalism
Courtesy
Helpfulness
Overall Customer Service

WARNING: This may get confusing. To earn Rewards credit for completing the survey, please open this link in a new web page -https://www.surveymonkey.com/r/VCFYKPL

THEN click the “Done” button below.

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