Cancer Health_Fall_2020

State of Wellness
Wellness is defined as the quality or state of being healthy in both body and mind, especially as the result of deliberate effort. Take our survey and let Cancer Health know about wellness in your life.
Do you have relationships with people who make you feel good about yourself?

YesNo
Do you have a network of people you can rely on for support?

YesNo
How often do you exercise?

Once a weekSeveral times a weekEvery dayI don’t exercise regularly.
Do you maintain a healthy and balanced diet?

YesNo
Do you get enough sleep each night?

YesNo
Do you smoke cigarettes?

YesNo
Do you drink alcohol?

FrequentlyOccasionallyI don’t drink alcohol.
Do you wear a face mask to protect yourself and others against COVID-19?

AlwaysSometimesNever
How often do you feel stressed?

All the timeFairly oftenNot very oftenNever
Do you use any of these methods to help manage your stress? (Check all that apply.)

Deep breathingExerciseListen to musicMeditateTake a bathWrite/journalYogaNone of the above
Do you regularly take time to unwind and relax?

YesNo
Do you utilize any wellness services provided through your cancer treatment center?

YesNo
How easily do you adapt to change?

Very easilySomewhat easilyNot easily
Do you regularly find ways to stimulate and challenge yourself mentally?

YesNo
Do you feel like your life has purpose?

YesNo
What year were you born?
What is your gender?

MaleFemaleTransgenderOther
What is your current level of education?

Some high schoolHigh school graduateSome collegeBachelor's degree or higher
What is your annual household income?

Less than $15,000$15,000-$34,999$35,000-$49,999$50,000-$74,999$75,000-$99,999$100,000 or more
What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
What is your ZIP code?
Enter the message as it's shown*
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State of Wellness