You must have JavaScript enabled to use this form. Please answer the following questions. (All answers are anonymous) 1. Are you interested in virtual wellness programs (i.e. weight loss, blood pressure)? - None -YesNo If you answered "yes", what programs would you be most interested in? (Select all that apply) Weight loss Blood pressure control Managing high blood sugar (pre-diabetes) Using Food as Medicine Grocery Store Tours Basics of Cooking Healthy Healthy on a Budget Popular Diets Done Right (Keto, Intermittent Fasting, etc.) Other… Enter other… 2. What have been your biggest worries and concerns during the past year? Select all that apply Finances Work stress Experiencing burnout Family/Friends Transportation Coworkers COVID-19 Housing Childcare Mental/Emotional Health Support/someone to talk to Difficulty coping Alcohol use Other… Enter other… 3. Would you be interested in any of the following to assist in coping with your worries and concerns? Select all that apply Counseling Stress reduction/management Community Resources Relaxation exercise More Wellness Challenges Topic Focus Groups Leadership Support Massage Chairs Yoga & other classes offered Mindfulness Based Stress Reduction Onsite Support Group(s) CAPTCHA Submit Leave this field blank
