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* 1. What statement best describes your current level of physical activity?

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* 2. When do you get most of your physical activity each day (choose one)?

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* 3. Select the statement that best describes your current intake of fresh or frozen fruits and vegetables.

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* 4. Select the statement that best describes your current tobacco use.

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* 5. Select the best description of your daily water intake

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* 6. Please select up to 5 wellness topics that interest you the most

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* 7. When is the best time for you to participate in wellness activities (check all that apply)?

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* 8. Are there any barriers  that prevent you from participating in wellness activities? (Check all that apply)?

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* 9. Please indicate which screening test(s) you would participate in if offered by your employer (your screening results will be confidential).

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* 10. How long should a wellness activity last?

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