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Questions marked with an * are required Exit Survey
 
 
* How often do you exercise?
 
6 -7 times/week
 
5-4 times/week
 
2-3 times/week
 
1x/week
 
rarely
 
Never
 
 
* Would you like to start exercising more?
 
Yes
 
No (if no why?______________________________________________________)
 
 
What could we do as an employeer to make exercise more appealing?__________________________________________________________________
 
 
 
* Would you exercise if you had something new to try..
 
Yoga
 
Kettle balls
 
exercise class
 
equipment to exercise with
 
DVD's showing new exercises
 
 
* Would you exercise more often if The Harbor had incentives?
 
Yes (if yes, pick incentives below)
 
No
 
Incentives of food, employees meals out
 
Cash
 
Food to take home
 
Paid time off
 
 
 
* Would you exercise at work if The Harbor offered classes?
 
Yes
 
No
 
It would depend on the class
 
 
* Food related Questions:

Would you life to reduce your intake of....
 
Salt
 
Carbohydrates
 
Fat
 
Sugar
 
all of the above
 
 
* If The Harbor was going to try and change some of the foods we eat, should we...
 
Change the recipes
 
Find different items
 
Take out items that are unhealthy
 
Please list your ideas__________________________________
 
 
* Do you think offering a "Tip a Week" to improve exercise and eating heathfully would be helpful?
 
Yes,
 
No
 
I would like to see __________________________________offered by The Harbor
 
 
* Would you like to see a calorie count of the foods that are offered at meals?
 
Yes
 
No ( if no, why______________________________________________)
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