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New Town Physical Activity Access Survey
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1.
Are you a current resident of New Town/ North Segment?
(Required.)
Yes
No
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2.
Age:
(Required.)
18-24 years
25-44 years
45-60 years
61 years and older
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3.
Gender:
(Required.)
Male
Female
Other
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4.
Do you use the walking path in the community? (Check one)
(Required.)
Multiple times per day
Daily
Weekly
Monthly
Never
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5.
Which of these facilities have you used? (Check All that Apply)
(Required.)
Outdoor Walking Path
Outdoor Track
Northern Lights Fitness Area
Northern Lights Gym
Diabetes Center Fitness Area
City Pool/Splashpad
Healing Horse Ranch
Golf Course
Rodeo Grounds
Baseball/Softball Diamonds
None
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6.
How often do you use the facilities listed above? (Check One)
(Required.)
Multiple times per day
Daily
Weekly
Monthly
Never
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7.
What are the main uses of the facilities for you? (Check All that Apply)
(Required.)
Access within the community: store, school, community building, etc.
Exercise
Recreation
Healthy Lifestyle changes
Social Interaction
Other (please specify)
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8.
Are you satisfied with the facilities in your community? (Check One)
(Required.)
Yes
No
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9.
How often do you participate in physical activities (walking, running, biking, gym, sports, etc.)?
(Required.)
Once a week
2-3 times a week
4-5 times a week
6+ times a week
Never
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10.
What suggestions do you have to improve access to physical activity in the New Town Community?
(Required.)
