Health Coaching Exit Survey

Thank you for taking the time to tell us about your experience with our health coaching programs. The information you provide is confidential and will be used to improve our health coaching programs.

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* 1. Member Information

Name

Employer

Email Address

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* 2. How long did you participate in your health coaching program?

0 - 3 Months

3 - 6 Months

6 - 9 Months

9 - 12 Months

Other (please specify)

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* 3. Which health coaching program did you participate in? (Select all that apply)

UFuel (Nutrition)

UMove (Physical Activity)

UBalance (Stress Management)

UBody (Weight Management)

UPlusOne (Prenatal)

UBreathe (Tobacco Cessation)

UBeat (Heart Health)

URest (Sleep Hygiene)

UFit (Advanced Physical Activity)

UCents (Financial Health)

U&Yours (Family Health)

UAgeWell (Longevity)

UCentered (Perimenopause, Menopause)

UBoost (Weight Management and Medication)

UThrive (Prediabetes, Diabetes Care)

UControl (General Health)

UPrevent (Cancer Resistance)

Other (please specify)

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* 4. What changes did you make to your health habits as a result of participating in your health coaching program?

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* 5. How confident are you that after participating in this health coaching program you can maintain your new healthy habits long-term?

Not at all Confident

Somewhat Confident

Confident

Very Confident

Not at all Confident

Somewhat Confident

Confident

Very Confident

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* 6. How satisfied were you with your health coach?

Not at all Satisfied

Satisfied

Very Satisfied

Not at all Satisfied

Satisfied

Very Satisfied

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* 7. How satisfied were you with your health coaching program?

Not at all Satisfied

Satisfied

Very Satisfied

Not at all Satisfied

Satisfied

Very Satisfied

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* 8. How likely are you to recommend health coaching to others?

Not likely

Likely

Very likely

Not likely

Likely

Very likely

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* 9. What did you like the most about your health coach?

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* 10. What did you like the most about your health coaching program?

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* 11. Why are you ending your participation in your health coaching program?

You completed (graduated) the program.

You can do this on your own.

Your employer is no longer offering this wellness benefit

You (or your spouse) are no longer employed with the company that offered this wellness benefit

You no longer have time to participate in the program

You no longer have an interest in participating in the program

Other (please specify)

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* 12. Will you participate in a health coaching program again in the future?

Yes

Not Sure

Other (please specify)

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* 13. Are there any changes that would have made your coaching program better?

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* 14. Please use this space to share any additional information about your experience with our health coaching programs.

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* 15. Can we share your feedback and include your name when sharing about the coaching program?

Yes, you can share my feedback and my name.

You can share my feedback anonymously (do not add my name)

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* 16. How likely is it that you would recommend this wellness company to a friend or colleague using a scale of 0 - 10 (with 0 being not likely and 10 being very likely)?

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* 17. Now, AFTER your participation in health coaching, how would you describe your current overall health and wellbeing compared to when you started?

Significantly Improved

Improved

Stayed the Same

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* 18. In the past month, how often have you engaged in behaviors that support your health goals?

Always

Often

Sometimes

Rarely

Never

Other (please specify)

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* 19. Now, after participating in your coaching program, how ready are you to make changes to improve your health and wellbeing?

Not Ready

Thinking about it

Preparing to make changes

Taking Action

Maintaining Changes

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* 1. Member Information

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* 2. How long did you participate in your health coaching program?

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* 3. Which health coaching program did you participate in? (Select all that apply)

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* 4. What changes did you make to your health habits as a result of participating in your health coaching program?

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* 5. How confident are you that after participating in this health coaching program you can maintain your new healthy habits long-term?

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* 6. How satisfied were you with your health coach?

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* 7. How satisfied were you with your health coaching program?

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* 8. How likely are you to recommend health coaching to others?

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* 9. What did you like the most about your health coach?

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* 10. What did you like the most about your health coaching program?

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* 11. Why are you ending your participation in your health coaching program?

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* 12. Will you participate in a health coaching program again in the future?

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* 13. Are there any changes that would have made your coaching program better?

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* 14. Please use this space to share any additional information about your experience with our health coaching programs.

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* 15. Can we share your feedback and include your name when sharing about the coaching program?

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* 16. How likely is it that you would recommend this wellness company to a friend or colleague using a scale of 0 - 10 (with 0 being not likely and 10 being very likely)?

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* 17. Now, AFTER your participation in health coaching, how would you describe your current overall health and wellbeing compared to when you started?

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* 18. In the past month, how often have you engaged in behaviors that support your health goals?

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* 19. Now, after participating in your coaching program, how ready are you to make changes to improve your health and wellbeing?

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* 20. How did your participation in your health coaching program help with your biggest challenge from the beginning of your coaching program?