GO Lake County Survey

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* 1. What was the date of the walk you attended?

Date / Time

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* 3. What is your Zip Code?

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* 4. What is your sex?

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* 5. Do you or anyone with you have any special needs or limitations?

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* 6. What is your Race?

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* 8. Has having GO walking events increased opportunities for you to be physically active?

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* 9. How important is having a walking program in your community?

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* 10. Did you participate in today's GO event with family or friends?

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* 11. If Yes, how many?

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* 12. What is your age and ages of all your participants?

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* 13. Where do you engage in physical activity (Please check all that apply)

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* 14. Are you walking to manage a medical or health condition?

T