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1. Exercise is an important part of healthy lifestyle. In which of the following activities do you regularly participate (at least two times per week)? Aerobics ClassesBicyclingGardeningHigh Involvement Organized Sports(Basketball, Football, Soccers etc..)Jogging/RunningMartial ArtsPower Walking / WalkingWeight Training / ToningYogaOther
2. In an average week, what is the total amount of time you spend doing the activities identified? 0-10 minutes11-20 minutes21-30 minutes31-39 minutesMore than 1 but less than 2 hours2-3 hoursMore than 3 hours
3. Please indicate any of the following that limits your ability to exercise fully. Financial LimitationsWork SchedulesFamily SchedulesHealth ConcernsStress
4. Which of these health topics are of interest to you? Healthy EatingPhysical Activity / FitnessWeight ManagementStress MangementSmoking CessationPrenatal CarePreventative ScreeningsComplementary & Alternative TherapiesDisease Management (diabetes, asthma, etc)None
