Dear Research Participant,

We are delighted you have agreed to participate in this important Healer Within Foundation research project! The purpose of the research is to demonstrate the dissemination and benefits of a replicable Tai Chi and Qigong program for the general public.

To begin, please complete this FIRST questionnaire below. Then, each week you will answer a few questions both before and after class. We’ll also ask you to complete an exit survey after the six or eight weeks class cycle.

Your responses will remain anonymous. We sincerely thank you for your time and valuable feedback!
 

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* 1. Your Information:

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* 2. Have you previously taken a class or regularly practiced Qigong or Tai Chi? (Please select one)

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* 3. If you answered Yes to Question 2, how often have you been practicing or attending class?

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* 4. If you answered Yes to Question 2, what forms of Tai Chi or Qigong do you normally practice?

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* 5. What are the main reasons for your medical/doctor visits? (Please check all that apply)

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* 6. Do you suffer from pain on a regular basis?

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