You can always press Enter⏎ to continue
Winter Survey Feedback Form
Hi there, please fill out and submit this form.
13
Questions
START
1
Name
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Email
example@example.com
Previous
Next
Submit
Press
Enter
3
Phone Number
Please enter a valid phone number.
Previous
Next
Submit
Press
Enter
4
Are you a Seven Movement member?
YES
NO
Previous
Next
Submit
Press
Enter
5
Do you live in Stockport?
YES
NO
Previous
Next
Submit
Press
Enter
6
Did you set out with a goal to lose weight this year?
YES
NO
Previous
Next
Submit
Press
Enter
7
If yes, how have you got on?
Previous
Next
Submit
Press
Enter
8
Did you set out with a goal to get fitter this year?
YES
NO
Previous
Next
Submit
Press
Enter
9
If yes, how have you got on?
Previous
Next
Submit
Press
Enter
10
What other goals are important to you?
Previous
Next
Submit
Press
Enter
11
Which option best describes your approach to nutrition?
I always make healthy food choices
I frequently make healthy food choices
I sometimes make healthy food choices
I rarely make healthy food choices
I never make healthy food choices
Previous
Next
Submit
Press
Enter
12
Do you currently struggle with nightime snacking?
Yes
Sometimes
No
Previous
Next
Submit
Press
Enter
13
Which option below best describes how much sleep you get per night?
Less than 4 hours a night
5-6 hours per night
6-7 hours per night
7-8 hours per night
8+ hours per night
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
13
See All
Go Back
Submit