Wellness Program Survey

Northland Health Centers are excited you have chosen to be part of the Wellness Program!
This challenge was designed to encourage overall wellness, consistent physical activity, and healthy diet choices. We hope you find this to be a fun experience for developing positive lifestyle changes.

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* 1. Participant Name

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* 2. What is your personal, measurable goal for the eight-week challenge?

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* 3. Report progress on your personal goal for week 7 - what actions did you take or what progress did you make toward meeting the overall goal?

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* 4. How many minutes of continuous exercise did you do each day?

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* 5. How many servings of fruits and/or vegetables did you consume each day?

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* 6. How many ounces of water did you consume each day?

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* 7. How many hours of sleep did you achieve each night?

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* 8. Did you write a daily gratitude?

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* 9. Have you completed the depression screening tools (on website and FB group) AND consulted a healthcare professional for positive results?

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* 10. Did you read or watch the educational material shared to the Facebook group for week seven?

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