Wellness Wednesdays

EVA Health & Wellness Interest Survey

The Project EVA (Empowering Vital Aging) team will be starting a "Wellness Wednesday" program in February 2018. We want to hear from you so our programs will be fun, informative and most of all, helpful in meeting your health and wellness goals. Please complete our survey by January 18 -- contact information is appreciated.

Question Title

* 1. Are you currently attending or have you attended any health and wellness classes taught by the Empowering Vital Aging team? (Check all that you have attended)

A Matter of Balance

Tai Ji Quan

Living with Chronic Conditions

Living with Diabetes

Powerful Tools for Caregivers

Other (please specify)

Question Title

* 2. If you have not attended an exercise or health and wellness class at East Side Neighborhood Services, would you be interested in attending?

Yes

Not sure

Question Title

* 3. What other topics would be of interest to you?

Healthy Eating

Healthy Heart

Health & Safety

Better Sleeping

Healthy Vision

Other (List topics you are interested in learning more about.

Question Title

* 4. Please share your contact information.

Name

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number