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Nisqually Health Fitness and Nutrition Program
We would like to know what the Nisqually Community wants and needs are so we can improve services provided to t he community.
1.
What is your affiliation with the Nisqually community?
Tribal member
Community member
Employee
2.
What is your age group?
14 to 17
18 to 29
30 to 40
41 to 54
55 and up (elder)
3.
What are your primary health and fitness goals? Select all that apply.
Weight loss
Muscle gain
Improved endurance
Stress reduction
General wellness
Other
4.
How would you describe your current level of physical activity?
Very active
Moderately active
Occasionally active
Not active
5.
What days of the week work best for you to participate in wellness activities? Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
6.
What times of day are most convenient for you to exercise? Select all that apply.
Early early early - Mornings 4am to 6am
Early mornings - 6am to 8am
Mornings - 8am to 12pm
Lunchtime - 12pm to 2pm
Afternoons - 2pm to 5pm
After work - 5pm to 7pm
Late evenings - 7pm to 9pm
Late late evenings - 9pm to 11pm
7.
How long should your wellness activity last, including changing and cleanup time?
30 minutes
45 minutes
1 hour
1- 1/2 hours
2 hours
8.
Are there any barriers (days/times) that prevent you from participating in exercise?
Yes
No
If yes (please specify)
9.
What types of wellness programs or services are you interested in? Select all that apply.
Yoga
Aerobics
Diabetes maintenance and or prevention
Strength training
Nutrition workshops
Mental health support
Healthy cooking/meal prep
Socializing /group activities
Stress managment
Other (please specify)
10.
Please provide name email and phone number to be entered to win a prize.
