Goal Survey Tap in to the power of goal setting! Writing your goals out and selectively sharing them increases your success in sticking with them! The following questions will help clarify your health goals. Thanks in advance for completing this 5-minute survey! Your privacy is important to me. Responses are confidential - Privacy Policy Question Title * 1. If there was one thing you could do to improve your health, what would it be? Lose weight Exercise more Eat healthier Drink more water Eat less sugar Get more sleep Other (please specify) Question Title * 2. How happy are you with YOUR health and fitness level? Very happy I could be more fit and healthy I am not happy at all Question Title * 3. What is your BIGGEST CHALLENGE RIGHT NOW you see as a roadblock to maintaining or improving YOUR health? Question Title * 4. How do you currently receive information about health and well-being? From friends or family My doctor or other healthcare provider Internet search Books or magazines Other (please specify) Question Title * 5. What are your top 3 goals for your health in the next 6 months? Goal #1 Goal #2 Goal #3 Question Title * 6. What would help you most in order to make positive changes in your health? Education about a healthy lifestyle Beginning an exercise program Having a coach or accountability partner Developing a healthy mindset Reducing stress in my day-to-day life Other (please specify) Question Title * 7. When thinking about your health, what is the number one thing you know you could be doing right now to improve your health: Get more sleep Get a check up from my health care provider Improve my diet Exercise more Manage my stress Other (please specify) Question Title * 8. Which strategies to improve your health have you tried in the past? Meditation, visualization, affirmations, or relaxation practice. Vegan, plant-based, gluten-free, dairy-free, or another special diet Spending time in nature Daily walks Cutting out sugar, snacking, or late night eating I haven't used tried any strategies to improve my health in the past Other (please specify) Question Title * 9. How do you prefer to receive information about health and wellness? I prefer this I do not like this Not sure In person. For example, one to one conversation. In person. For example, one to one conversation. I prefer this In person. For example, one to one conversation. I do not like this In person. For example, one to one conversation. Not sure Audio. For example, a podcast. Audio. For example, a podcast. I prefer this Audio. For example, a podcast. I do not like this Audio. For example, a podcast. Not sure Written. For example, a blog or a book. Written. For example, a blog or a book. I prefer this Written. For example, a blog or a book. I do not like this Written. For example, a blog or a book. Not sure Internet search. Internet search. I prefer this Internet search. I do not like this Internet search. Not sure Group discussion. For example, a women's only meeting. Group discussion. For example, a women's only meeting. I prefer this Group discussion. For example, a women's only meeting. I do not like this Group discussion. For example, a women's only meeting. Not sure Video. For example, Youtube. Video. For example, Youtube. I prefer this Video. For example, Youtube. I do not like this Video. For example, Youtube. Not sure Question Title * 10. Complete this section if you're ready to upgrade your health! You do not have to provide any or all of this information in order for your survey results to be submitted. SIMPLY CLICK DONE AT THE BOTTOM OF THE SCREEN if you're not interested in hearing more about health from me.Thank you for participating in the survey! Name ZIP/Postal Code Email Address Phone Number Done