Employee Wellness Survey

An employee wellness survey is an effective way to get information from your employees. An employee wellness survey asks what the employees want from a wellness program. An employee wellness survey gives employees a feeling of ownership and involvement in the decision making process. The employee wellness survey should only request information that the health promotion program can accommodate in the future. A wellness program can be geared towards an employee’s preferences and interests after evaluating the results of the employee wellness survey

Employee Wellness Survey (Sample)

This employee wellness survey is designed to gather your input and feedback as to the employee wellness programs you would like to see included wellness initiative.  Please take a few minutes to complete this employee wellness survey.  If you have questions about this employee wellness survey then let us know – we are happy to help in any way we can.

Would you like (insert company name) to have an employee wellness program?

____ Yes    ____ No

If yes, please indicate which of the following programs/services you’d like to see included in the employee wellness program.

Nutrition seminars:
____ Basic Nutrition Information (portion sizes, healthy eating)
____ Healthly Cooking Demonstrations
____ Healthy Eating with Heart Disease or Hypertension
____ Managing Your Diabetes
____ Fast Food/Dining Out Tips
____ Reading Food Labels
____ Other: ___________________________

____ Healthy food options in the Cafeteria
____ Healthy options in the Snack / Vending Machines
____ Weight management and/or weight loss program
____ Employee Gym / Employee Fitness Center

Group Exercise / Aerobics Classes:
____ Yoga/Pilates
____ Tai Chi
____ Kickboxing / Boot Camp
____ Aerobics
____ Line Dancing
____ Ballroom Dancing / Salsa Dancing
____ Other: ____________________

Personal Growth and Alternative Seminars:
____ Stress Reduction / Stress Management
____ Guided Imagery and / or Meditation
____ Time Management Training
____ Organization Skilss Training / Interior Design
____ Sleep and the Importance of Getting a Good Nights Rest
____ Seasonal Affective Disorder (SAD) / Depression / Anxiety
____ Herbs, Vitamins and Supplements
____ Increasing Your Creativity through Crafts
____ Retirement Planning
____ Parenting Issues and Coping Skills
____ Building Self Esteem
____ Computer Training Classes
____ Other: _________________________________

____ Smoking Cessation / Tobacco Cessation
____ Volunteer Programs
____ Employee Health Screening (Lipid, Blood Glucose, Body Fat Analysis, Onsite Mammography)
____ Other Wellness Programs: ________________________________

What time of the day is best for Health Education / Wellness Seminars and Activities? ____________________

Would you be willing to complete a Health Risk Assessment Questionnaire so we could provide programs that would best meet your needs or interests?

____ Yes    ____ No

Are you interested in teaching a seminar / class for the wellness program?

____ Yes    ____ No     If yes, please list class topic and contact information: ________________________

Thank you for taking time to complete this employee wellness survey.  We value your opinion and appreciate your input.

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