Examples of Wellness Programs, but not limited to:
Tobacco use and control
Smoke free environment
Smoking cessation classes
No cost nicotine gum, patches or prescription medications
Shared cost smoking cessation products
Stop smoking counseling or support groups
Exercise Resources
On-site exercise equipment
Employee / staff / participant exercise opportunities given on site
Walking groups or staff / participant challenges
Incentives given for healthy behaviors
Diet/ nutrition
Availability / access to healthy snacks
Availability / access to healthy drink choices i.e. water/juice
Availability / access to nutrition information /counseling
Availability / access to weight loss or fitness programs
Adequate break / lunch time provided for healthy eating

Please answer these questions as they relate to your business, facility, organization, or other entity.

1. Are wellness programs offered to employees, clients, or the public?
Yes No
If you answered NO to Question 1 please skip to Question 9
2. Which of the following is offered pertaining to each topic? (mark all that apply)
A. Tobacco use and control
Smoke free environment
Smoking cessation classes
No cost nicotine gum, patches or prescription medications
Shared cost smoking cessation products
Stop smoking counseling or support groups
Other:
B. Exercise Resources
On-site exercise equipment
Employee / staff / participant exercise opportunities given on site
Walking groups or staff / participant challenges
Incentives given for healthy behaviors
Other:
C. Diet/ nutrition
Availability / access to healthy snacks
Availability / access to healthy drink choices i.e. water/juice
Availability / access to nutrition information /counseling
Availability / access to weight loss or fitness programs
Adequate break / lunch time provided for healthy eating
Other:
3. Are programs located:
On site Off Site
4. Program availability (scheduling): (mark all that apply)
During the workday
Before or after work
Both of the above
On employee / staff personal time only
Other:
5. Cost of programming is covered by: (mark all that apply)
Employer / director / agency
Employee / staff / participants
Shared cost or subsidized
Discounted rates
There are no charges associated with programs
Other:
6. Programs are offered: (mark all that apply)
Ongoing
Quarterly
Monthly
Once yearly
Other:
7. Identify barriers to participation: (mark all that apply)
Lack of adequate time to participate
Low motivation to participate
Access issues to participate (location, timing)
Cost prohibitive
Other:
No barriers identified
8. Of the services or program provided, which is the most successful
Smoking cessation
Exercise opportunities
Diet and nutrition
Health screening
Other:
9. What gaps in health and wellness services (health promotion programs) do you see in your community? (mark all that apply)
Smoking cessation opportunities
Exercise opportunities
Diet and nutrition education
Health screening availability
Other:
10. Please identify your community:
Holden
Leeton
Warrensburg
Centerview
Chilhowee
Knob Noster
Kingsville
Other :
11. What is your primary business or industry?
Private Business
School
Non-profit
City government
County government
State government
Other :
Additional comments…

 
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