Employee Wellness Interest Survey

Please help us learn more about your health needs and interests by taking a few minutes to fill out this survey. Your responses are important and will help us to plan future wellness activities for employees at SPIN, Inc. We appreciate your input and look forward to a successful wellness program!

Please note this survey is anonymous. There are no right or wrong answers, so please answer honestly. If you have any questions, contact wellness@spininc.org.

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* 1. What is your gender?

Female

Male

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* 2. What is your age range?

Under 20

20-30

31-40

41-50

51-60

61-70

Over 70

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* 3. Which best describes your work location?

Drummond Road

Frankford

Norcom Community Center

Vernon Road Offices

SPIN NE Residential Home

SPIN WEST Residential Home

Multiple SPIN locations

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* 4. To what extent do you agree or disagree with the following statement: I am interested in learning about the following topics...

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
Allergy Awareness	Allergy Awareness Strongly agree	Allergy Awareness Agree	Allergy Awareness Neutral	Allergy Awareness Disagree	Allergy Awareness Strongly disagree
Better Sleep	Better Sleep Strongly agree	Better Sleep Agree	Better Sleep Neutral	Better Sleep Disagree	Better Sleep Strongly disagree
Brain Health	Brain Health Strongly agree	Brain Health Agree	Brain Health Neutral	Brain Health Disagree	Brain Health Strongly disagree
Cancer Prevention	Cancer Prevention Strongly agree	Cancer Prevention Agree	Cancer Prevention Neutral	Cancer Prevention Disagree	Cancer Prevention Strongly disagree
Children's Health Issues	Children's Health Issues Strongly agree	Children's Health Issues Agree	Children's Health Issues Neutral	Children's Health Issues Disagree	Children's Health Issues Strongly disagree
Diabetes Awareness	Diabetes Awareness Strongly agree	Diabetes Awareness Agree	Diabetes Awareness Neutral	Diabetes Awareness Disagree	Diabetes Awareness Strongly disagree
Fitness/Exercise	Fitness/Exercise Strongly agree	Fitness/Exercise Agree	Fitness/Exercise Neutral	Fitness/Exercise Disagree	Fitness/Exercise Strongly disagree
Gym discounts/memberships	Gym discounts/memberships Strongly agree	Gym discounts/memberships Agree	Gym discounts/memberships Neutral	Gym discounts/memberships Disagree	Gym discounts/memberships Strongly disagree
Healthy cooking/Eating	Healthy cooking/Eating Strongly agree	Healthy cooking/Eating Agree	Healthy cooking/Eating Neutral	Healthy cooking/Eating Disagree	Healthy cooking/Eating Strongly disagree
Heart Disease (Blood presssure, cholesterol)	Heart Disease (Blood presssure, cholesterol) Strongly agree	Heart Disease (Blood presssure, cholesterol) Agree	Heart Disease (Blood presssure, cholesterol) Neutral	Heart Disease (Blood presssure, cholesterol) Disagree	Heart Disease (Blood presssure, cholesterol) Strongly disagree
Nutrition Information/Nutrition Counseling	Nutrition Information/Nutrition Counseling Strongly agree	Nutrition Information/Nutrition Counseling Agree	Nutrition Information/Nutrition Counseling Neutral	Nutrition Information/Nutrition Counseling Disagree	Nutrition Information/Nutrition Counseling Strongly disagree
Smoking Cessation	Smoking Cessation Strongly agree	Smoking Cessation Agree	Smoking Cessation Neutral	Smoking Cessation Disagree	Smoking Cessation Strongly disagree
Stress Management	Stress Management Strongly agree	Stress Management Agree	Stress Management Neutral	Stress Management Disagree	Stress Management Strongly disagree
Summer Safety	Summer Safety Strongly agree	Summer Safety Agree	Summer Safety Neutral	Summer Safety Disagree	Summer Safety Strongly disagree
Weight Watchers at Work Program	Weight Watchers at Work Program Strongly agree	Weight Watchers at Work Program Agree	Weight Watchers at Work Program Neutral	Weight Watchers at Work Program Disagree	Weight Watchers at Work Program Strongly disagree
Weight Management	Weight Management Strongly agree	Weight Management Agree	Weight Management Neutral	Weight Management Disagree	Weight Management Strongly disagree
Women's Health Issues	Women's Health Issues Strongly agree	Women's Health Issues Agree	Women's Health Issues Neutral	Women's Health Issues Disagree	Women's Health Issues Strongly disagree
Work/Life Balance	Work/Life Balance Strongly agree	Work/Life Balance Agree	Work/Life Balance Neutral	Work/Life Balance Disagree	Work/Life Balance Strongly disagree

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* 5. What is the best way for you to hear about various wellness activities? Check all that apply.

E-mail

Flyers/Posters

Reminders in Paychecks

Bulletin Boards

Newsletters

SPIN Portal

Other (please specify)

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* 6. What days of the week are best for you to participate in wellness activities? Check all that apply.

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

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

Morning

Afternoon

Evening

Other (please specify)

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* 8. How much time would you be willing to devote to a wellness activity?

Less Than 30 Minutes

30-45 Minutes

45-60 Minutes

1-2 Hours

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* 9. Would you prefer to participate in activities in a group or individually?

Individually

Group

Both

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* 10. What prevents you from participating in a wellness activity?

Lack of Time

Lack of Motivation

Lack of Interest

Depends on the activity

N/A, I am interested

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* 11. Would you be more inclined to participate in wellness activities if children could attend?

Yes

Depends on the activity

N/A

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* 12. Would you be interested in volunteering for a wellness program, activity, or health fair?

Yes

If yes, in what way could you help?

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* 1. What is your gender?

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* 2. What is your age range?

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* 3. Which best describes your work location?

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* 4. To what extent do you agree or disagree with the following statement: I am interested in learning about the following topics...

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* 5. What is the best way for you to hear about various wellness activities? Check all that apply.

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* 6. What days of the week are best for you to participate in wellness activities? Check all that apply.

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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. How much time would you be willing to devote to a wellness activity?

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* 9. Would you prefer to participate in activities in a group or individually?

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* 10. What prevents you from participating in a wellness activity?

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* 11. Would you be more inclined to participate in wellness activities if children could attend?

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* 12. Would you be interested in volunteering for a wellness program, activity, or health fair?

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* 13. Do you have any additional comments or suggestions?