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Survey

Survey

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1.

Please let us know the reason you are on the waiting list for 1-1 support:

* required*

To improve my diet

To increase my physical activity

To reduce the amount of alcohol I drink

Other (please specify)

2.

Would you be interested in receiving support in a group setting?

* required*

Yes

No

Other (please specify)

3.

We would like to give information on a range of different topics, please let us know which ones you would be interested in learning more about:

* required*

Nutrition

Portion control

Trigger foods feeling and environment

Food labels

Eating out

Alcohol

Importance of physical activity

Planning ahead

Mindfulness

Mental wellbeing

Finance

Sleep

Stress

Musculoskeletal health (bones, muscles and joints)

Other (please specify)

4.

How long would you like this course to be:

* required*

6 sessions

9 sessions

12 sessions

Don't know

Other (please specify)

5.

If you would like us to contact you further regarding this group, please could you provide an email address:

6.

Any other comments:

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