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Health & Wellness Day Survey
1.
What is your first and last name?
2.
Would you be interested in participating in a Health & Wellness Day?
Yes
No
3.
Which of the following activities interest you? Please check all that apply.
Meditation
Pilates
Yoga
Dance Movement
Stretching
Music/Self Expression
Massages
Motivational Speaker
Cooking Demonstration
4.
Which of the following healthy eating techniques interest you? Please check all that apply.
Macrobiodics (A diet avoiding refined foods and most animal products)
Vegan/Vegetarianism
Farm to Table (Refers to the various processes in the food chain from agricultural production to consumption)
Gluten Free
No Sugar Diet
How to use your kitchen as a pharmacy
Healthy substitutions for everyday eating
Ayurveda (Based on the idea of balance in bodily systems and uses diet, herbal treatment, and yogic breathing)
5.
Would you be able to travel to Manhattan around late September-early October to participate in this day event?
Yes
No
Other (please specify)
6.
What day would work best for you? Please note this would likely be a full morning and afternoon event. Please check all the apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
7.
If you have ever participated in a Health & Wellness event what did you like/dislike?
8.
What would your ideal Health & Wellness event include?
9.
Do you have any additional questions or comments?