Seventh-day Adventist® Church

Watford Town …a place to belong, believe, become

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WTC Health Form Q2 2014

* Indicates required field.

We are conducting a brief health survey here at Watford Town Church.

 

Please respond to the questions below.

The results will be compiled and then made available to the church.

Please note that no personal information is captured - the data is all anonymous.

Online
From Paper
In good physical health.
Average physical health
Below Average physical health.
Poor physical health.
Other.
Member
Regular Visitor
Related to a Member
Friend of a Member
Former Member
Unknown
Daily
Several times a week
Weekend
None
Other
None
10 - 20 mins
20 - 40 mins
40+ mins
High degree of social support.
Above average degree of social support.
Average degree of social support.
Below average degree of social support.
No support or potential support.
You basically eat what you want including meat, fish, eggs, cheese, sugar.
You eat most things apart from meat.
You are aovo-vegetarian which includes eggs but not dairy products.
You are a ovo-lacto vegetarian which includes both eggs and dairy products.
You are a vegan, or strict vegetarian, which excludes all animal products, including eggs, dairy.
None
Once
Two - Four
Other
None
1 - 3
4 - 6
Other
Yes
No
Small changes
Other
None
1 - 3
4 - 7
Other
1-2
3
4 or more
Other
15-18
19-23
24-30
31-51
53-65
65+
Live with spouse only
Live with spouse and children
Live alone
Other
3 - 4 hours
5 - 7 hours
8 + hours
Other
None
Occasionally
Often
Other
Yes
No
Sometime
Yes
No
Sometimes
Other
Male
Female
Married
Divorced
Widowed
Never been married
Retired
Employed Full Time
Employed Part Time
Unemployed
Student