MStrong Exercise Program
1.
Do you attend the monthly support group? The group meets the 2nd Tuesday of every month, Bismarck Library, 7:00 pm in the basement, Meeting Room C.
Every Month
Every other month
Every 2-3 months
Once or twice a year
No
2.
Please select your age range.
Under 18
18-24
25-34
35-44
45-54
55-64
65+
3.
Do you currently work?
Yes
No
4.
What time of day would you attend an exercise program for those with MS?
Early morning (6am-9am)
Mid morning (9am-11am)
Afternoon (11am-1pm)
Late afternoon (1pm-4pm)
Evening (4pm-6pm)
Late evening (6pm-)
5.
What day/s of the week would you attend an exercise program for those with MS?
Monday/Wednesday
Tuesday/Thursday
Monday/Friday
Tuesday/Friday
Monday/Thursday
Sunday/Tuesday
Sunday/Wednesday
Sunday/Thursday
Monday
Tuesday
Wednesday
Thursday
Friday
Sunday
6.
What workout environment do you prefer most?
Exercising independently
Exercising in a group
Exercising with others that have an MS diagnosis
Exercising with supervision
Exercising in a private space
7.
What is your biggest barrier to exercise (from the list below.)
Lack of time
Lack of transportation
Cost of membership
Location of facility
Not interested in an exercise program
Fear of injury/relapse
Day/time of classes
8.
Are you currently in the MStrong program?
Yes
No
9.
If you would like to be contacted to discuss the program or your answers please provide your name and phone number or email.