Tucker First United Methodist Church
Tuesday, September 07, 2010

Health & Wellness Ministry Survey

In an effort to meet the congregation’s needs and interests by providing desired services, we invite your input.
 

SECTION I – Desired Services and Programs

 
If programs/services of interest to you were offered, would you attend:  Yes  No
 
If no, why not?
Too busy  Not interested  Time programs offered  Single parent
Don’t drive at night Can get information elsewhere
Other - be specific
 
If yes, what day(s)/time(s) would you prefer? Check all days that apply and list times
 
Days? Times?
(enter AM or PM)
Sat 
Sun 
Mon
Tue
Wed
Thu
Fri

  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If yes, what topics/programs/services would you like (check all that apply)?
 
Nurse services   B/P screenings   Flu shots  Printed info  
Health fairs  Blood drives
 

Program Topics: 

(Check all you would be interested in)

1 - Wellness, Prevention, Health Promotion: 

 
Alcohol/Drugs  Allergy/Asthma   Anger/Violence Arthritis  Back Pain
Cancer CPRDeath, Dying, Grief & Loss  Dementia  Depression  
De-stressing the Holidays  Diabetes  Exercise  First Aid  Food Safety  
Healthy Eating   Heart Disease   Hepatitis  HIV/AIDS  Healthy Aging  Osteoporosis  Safety  Self Esteem  Smoking Cessation
Stress Management Stroke Weight Loss/Control Winter Wellness
 

2 - Family Related:

 
Care Giving Childhood Growth and Development
Communication in the Family   Divorce Eldercare
Infant/Newborn Mid-Life Crisis Pregnancy
Sex Education for Adolescents Parenting Single Parenting
Womens/Mens Issues

3 - Spirituality & Ethical Issues:

 
Abortion Advance Directives  Alternative Therapies
Cloning/Stem Cell Research  Healing Services  Health Ministry
Holistic Health  Meditation/Prayer  Organ Donation  Quality of Life
 
Other Programs, specify: 
 

SECTION II – Active participation

 

We’d love to have you be an active part of our Health and Wellness Ministry - whether for a single event or on an ongoing basis.  Please indicate your area of interest and/or expertise and we’ll contact you. 

Check all that apply:
 
Health and Wellness Committee Blood Drives Computer Issues
General Help Health Fairs Hospitality (Baking/Food Supply)
Host at Programs Publicity Telephoning Transportation

BP Screenings   Health Care Resource
I am a(n)   MA, EMT, RN, NP, PA, DO, MD
 
Support Group Facilitator  Specify
Program Speaker  Topic(s)
 
Availability: 
Check all that apply: 
 
Weekdays
Weekends
Mornings
Afternoons
Evenings
 
 Fall  Winter  Spring   Summer
 
Occasional     On-going 
 
 
 Name (needed for us to contact you)
 Daytime phone
 Evening/cell phone
 E-mail address

 
Is there anything else you want us to know?
 
 
THANK YOU!
 Questions? Contact Susan Wasmer.