The Healthy Lifestyles Blood Pressure Lending Library Program is now accessible to all Salt Lake County Employees aiming to track their Blood Pressure levels on a daily basis for one month.
Before we begin, please take a moment to read thoroughly and complete the agreement form and the pre-survey. Answer the questions to the best of your knowledge. Our aim is to help you enhance your understanding of blood pressure and your own body's readings by monitoring your blood pressure daily and utilizing the resources we provide.
Please read through the following agreement form. Click on the BLUE BOLDED TEXT to read the form, then return to this survey to type your initials, to agree to the terms.

Question Title

* 1. By initialing in the comment box below, I CONFIRM that I have read through the Blood Pressure Lending Library Agreement form and that I AGREE to the agreement form. (Please provide first and last name initials)

Question Title

* 2. What is your first and last name?

Question Title

* 3. What is your EIN (Employee ID Number)? If you are an adult designee, at + 1 to the end of your employee's number.

Question Title

* 4. What is the best way to contact you?

Question Title

* 5. What is your contact information?

Question Title

* 6. Watch the following video to learn how to take your Blood Pressure.

Question Title

* 7. How did you hear about the Blood Pressure Lending Library? 

Question Title

* 8. What is your age range? 

Question Title

* 9. What is your gender?

Question Title

* 10. What race of ethnicity best descibes you?

Question Title

* 11. How often would you say that your meals eaten are well-balanced? (Emphasizes on vegetables, fruits, whole grain, dairy products, including lean meats, poultry, fish, beans, eggs and nuts. Limited on saturated and trans fats, sodium and added sugars.) 

Question Title

* 12. Do you use tobacco products?

Question Title

* 13. What type of physical activity do you currently participate in?

Question Title

* 14. How many minutes are you physically active each week?

Question Title

* 15. Have you talked with a doctor about your blood pressure recently? (Within the last 6 months) 

Question Title

* 16. On a scale from 0-100, 0 being extremely unlikely, and 100 being extremely likely, how likely are you to talk with a doctor about your blood pressure currently?

0 50 100
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* 17. What is systolic pressure?

Question Title

* 18. What it diastolic pressure?

Question Title

* 19. What is the recommended systolic and diastolic numbers to fall at or below? 

Question Title

* 20. What does hypotension mean?

Question Title

* 21. What does hypertension mean?

Question Title

* 22. When should you talk with a doctor about your blood pressure? Select all that apply. 

T