Family Health & Wellness Survey

Are you male or female?

Male

Female

What are your children's ages? (Select all that apply)

If you, or a family member gets sick, where do you go for health information? (Select all that apply)

Physician

Family member, friend or neighbor

The Internet (e.g., google search, social media, group or forum, specific website such as webmd.com)

Books, magazines, journals

In-person seminar or workshop

How many times have you and/or a family member visited a doctor in the past year? (combined visits)

0

1-2

3-5

6+

Have you ever experienced a natural healing therapy such as yoga, acupuncture or Reiki etc?

Yes

No

What types of natural healing therapies have you experienced? (Select all that apply)

Acupressure (e.g., Reflexology, Jin Shin Jyutsu)

Hands-on healing modalities (e.g., Reiki, Healing Touch)

Hypnosis

Meditation (including guided imagery or visualization)

Tai Chi/Qi Gong

Yoga

Other

Are you interested in learning simple and gentle natural healing techniques to help yourself and your family?

Yes

No

What types of health information for physical issues are of interest to you? (Select all that apply)

What types of health information for emotional/behavioral issues are of interest to you? (Select all that apply)

What is the most convenient or preferred way to receive information to help yourself and your family?

Books, Magazines, CDs, DVDs

Online read-only resources

Online interactive resources (i.e., downloadable audio and video)

Mobile apps

Other