St. Teresa of Avila Community Health Survey

Thank you for taking the time to complete this anonymous survey. Results will be used to develop programs and activities to meet our community's holistic wellness needs in mind, body, and spirit. Please pray God will bless this ministry.

Question Title

* 1. Which category below includes your age?

Between 17 and 22

Between 23 and 45

Question Title

* 2. Select all topics you would most likely be interested in learning about?

Immunizations and vaccinations

Alzheimer's

Diabetes

Cancer

Heart Disease

Hypertension

Stroke

Infectious Disease Management/Prevention

Alcohol Addiction / Recovery

Tobacco Addiction / Recovery

Drug Addiction/ Recovery

Food Addiction/ Recovery

Depression / Anxiety / Suicide

Loneliness / Loss / Grief

Caring for Aging Parents

Caring for Infants / Toddlers

Caring for School age kids/ Adolescents

Bullying Prevention

Creating / Improving Relationships

Promoting a healthy marriage

Benefits of meditation

Alternative medicine / therapies

Adult Obesity Prevention

Child Obesity Prevention

Financial / Budget Management

Other (please specify)

Question Title

* 3. What are you health concerns?

Question Title

* 4. What are your health goals?

Question Title

* 5. Do you currently have a primary care doctor or nurse practitioner?

Yes

Other (please specify)

Question Title

* 6. Do you currently have health insurance (private, Medicare, Medicaid), or not?

Yes, I do

No, I do not

Question Title

* 7. Are you interested in helping with the Health Ministry?

Yes. Please email SaintTwellness@gmail.com and provide your name, email, and best phone number to reach you.

Maybe in the future

Other (please specify)

Question Title

* 1. Which category below includes your age?

Question Title

* 2. Select all topics you would most likely be interested in learning about?

Question Title

* 3. What are you health concerns?

Question Title

* 4. What are your health goals?

Question Title

* 5. Do you currently have a primary care doctor or nurse practitioner?

Question Title

* 6. Do you currently have health insurance (private, Medicare, Medicaid), or not?

Question Title

* 7. Are you interested in helping with the Health Ministry?

Question Title

* 8. Other suggestions / comments?