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Employee Wellness Committee Survey

  1. Gender

  2. Age Demographics

  3. When you are at work, which of the following best describes what you do?

  4. I find the following program(s) helpful and would like for them to remain in place (Check all that apply)

  5. What department do you work in?

  6. What is your employment classification

  7. Are you familiar with?: (Check all that apply.)

  8. How likely are you to participate in a wellness/health promotion program at work?

  9. How long should a wellness/health promotion activity last?

  10. There are many ways to disseminate health information at the worksite. What communication method(s) do you prefer? Check all that apply

  11. What time of day would be best for you to participate in a wellness/health promotion activity?

  12. Which topic would you like to see in a wellness/health promotion program? Check all that apply.

  13. Incentives are gifts or prizes to motivate participation in programs at work. How do you feel about incentives?

  14. Which incentives would motivate you the most? (Pick three)

  15. Would you be willing to pay a nominal fee for some wellness/health promotion activities?

  16. My employer provides opportunities for me to be physically active?

  17. Are there any aspects of your work environment that should be changed to be more supportive of a healthy lifestyle?

  18. Do you feel your health, safety and well-being is an important priority for management?

  19. I feel that Deerfield is a place where employees take pride in their work and have a great deal of togetherness.

  20. What might prevent you from participating in a wellness/health promotion program? (Check all that apply)

  21. If Deerfield offered an incentive that paid entrance fees for you to participate in charity walks, 5k or 10k walks/runs, and marathons, would you take advantage and participate?

  22. Leave This Blank:

  23. This field is not part of the form submission.