Living Well Class Completion Survey

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* 1. First Name

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* 2. Last Name

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* 3. What is your 6-Digit Employee Identification Number?
(SLCo Employee = EIN; SLCo Employee Designee = EIN + 1)

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* 4. Please select:

Male

Female

Non-binary

Prefer not to say

Prefer to self-describe

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* 5. Your age group:

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 6. Are you a current Healthy Lifestyles participant?

Yes

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* 7. What is the name of the class that you enrolled in?

Walk With Ease

EnhanceFitness

Living Well with Diabetes

Living Well with Chronic Conditions

Tai Chi for Arthritis

Living Well with Chronic Pain

Stepping On

Other (please specify)

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* 8. What is the main reason you registered for a Living Well Class?

Motivation to move

Have fun

Learn something new

Help better my current health condition

Support someone who deals with a chronic health condition

Trying to figure out how to deal with a recent diagnosis

Other (please specify)

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* 9. What format was the class held in that you attended?

In-person

Online

Hybrid

Self-Lead

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* 10. Did you like the format that which the program was conducted and why?

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* 11. How would you rate your experience with the Living Well Class?

	Very Dissatisfied	Dissatisfied	Neither satisfied nor dissatisfied	Satisfied	Very Satisfied
Class Time	Class Time Very Dissatisfied	Class Time Dissatisfied	Class Time Neither satisfied nor dissatisfied	Class Time Satisfied	Class Time Very Satisfied
Class Instructor	Class Instructor Very Dissatisfied	Class Instructor Dissatisfied	Class Instructor Neither satisfied nor dissatisfied	Class Instructor Satisfied	Class Instructor Very Satisfied
Education and materials that were taught and provided	Education and materials that were taught and provided Very Dissatisfied	Education and materials that were taught and provided Dissatisfied	Education and materials that were taught and provided Neither satisfied nor dissatisfied	Education and materials that were taught and provided Satisfied	Education and materials that were taught and provided Very Satisfied

Comments:

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* 12. In your opinion, did attending the class have any positive effect on your health?

Yes

If yes, what was the positive effect that the class had?

Living Well Class Completion Survey

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. What is your 6-Digit Employee Identification Number?
(SLCo Employee = EIN; SLCo Employee Designee = EIN + 1)

Question Title

* 4. Please select:

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* 5. Your age group:

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* 6. Are you a current Healthy Lifestyles participant?

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* 7. What is the name of the class that you enrolled in?

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* 8. What is the main reason you registered for a Living Well Class?

Question Title

* 9. What format was the class held in that you attended?

Question Title

* 10. Did you like the format that which the program was conducted and why?

Question Title

* 11. How would you rate your experience with the Living Well Class?

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* 12. In your opinion, did attending the class have any positive effect on your health?

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* 13. On a scale of 1-5 (1 being not likely and 5 being very likely), how likely are you to apply any information you learned during this program?

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* 14. What did you learn from attending the Living Well class?

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* 15. Is there anything that you disliked from the class that you attended?

Living Well Class Completion Survey

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. What is your 6-Digit Employee Identification Number?(SLCo Employee = EIN; SLCo Employee Designee = EIN + 1)

Question Title

* 4. Please select:

Question Title

* 5. Your age group:

Question Title

* 6. Are you a current Healthy Lifestyles participant?

Question Title

* 7. What is the name of the class that you enrolled in?

Question Title

* 8. What is the main reason you registered for a Living Well Class?

Question Title

* 9. What format was the class held in that you attended?

Question Title

* 10. Did you like the format that which the program was conducted and why?

Question Title

* 11. How would you rate your experience with the Living Well Class?

Question Title

* 12. In your opinion, did attending the class have any positive effect on your health?

Question Title

* 13. On a scale of 1-5 (1 being not likely and 5 being very likely), how likely are you to apply any information you learned during this program?

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* 14. What did you learn from attending the Living Well class?

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* 15. Is there anything that you disliked from the class that you attended?

* 3. What is your 6-Digit Employee Identification Number?
(SLCo Employee = EIN; SLCo Employee Designee = EIN + 1)