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* 1. How long have you been the Wellness Ambassador for your agency?

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* 2. Prior to starting this role, did you receive any training from the previous Wellness Ambassador?

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* 3. Please indicate your level of experience as an Wellness Ambassador.

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* 4. Are the employees at your agency familiar with the TCLW program?

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* 5. If you answered yes to the previous question, do they regularly participate in the activities or events?

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* 6. Do you know where to locate Well-Being Connect (Healthways portal)?

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* 7. If you answered yes to the previous question, are you familiar with Well-Being Connect?

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* 8. Have you completed your Well-Being 5 Survey this program year (7/1/15-6/30/16)?

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* 9. Have you participated in any of the statewide TCLW challenges in the past?

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* 10. Do you feel that you have agency leadership support?

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* 11. Have you completed either the Online Pathway or any Coaching Calls?

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* 12. Are you familiar with the QuitNet tobacco cessation program or the Diabetes Prevention Program?

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* 13. Do you know where to find the Wellness Ambassador Portal?

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* 14. Do you know where to find the Physician Form?

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* 15. Are you able to locate the Wellness Events calendar on the TCLW website?

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* 16. Do you regularly attend the in-person Wellness Ambassador meetings?

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* 17. If you answered yes to question 16, what do you hope to gain by attending the Wellness Ambassador meetings?

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* 18. If you answered yes to question 16, do you believe the Wellness Ambassador meetings are valuable and worth the time spent away from your office?

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* 19. If you answered no to question 16, what should be changed about the Wellness Ambassador meetings?

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* 20. What topics would you like to see on future Wellness Ambassador meeting agendas?

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* 21. Do you regularly attend the Wellness Ambassador monthly conference calls?

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* 22. Do you know where to direct colleagues who have questions about the TCLW program?

Thank you for completing this survey.  Your feedback is truly appreciated.

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