Fitness & Wellness Program Survey Form
We need your input in creating a Wellness Program for Hospitality Workers!
Thank you for helping us with your valuable input!
Serving Up Support: Maine is in talks with local fitness & wellness professionals in Maine to create a free well-rounded Wellness Program for Hospitality Workers. We need valuable feedback from Hospitality Workers of all ages and backgrounds to help us develop our program to see what your needs and expectations are. We'd greatly appreciate it if you'd take the time to fill out the form below to help us create a wellness program dedicated to YOU! Thank you again for your support and feedback! **The information gathered by this survey is anonymous and is only being used to create a health & wellness program tailored to the needs of Hospitality Workers.**
1. Demographic Information
Please select your age range.
Under 18
18-24
25-34
35-44
45-54
55+
How do you identify?
Male
Female
Non-binary/Third Gender
Prefer not to say
2. Work-Related Information
What is your role in the Hospitality Industry?
Server/Waitstaff
Chef/KitchenStaff
Housekeeping
Bartender
Musician/Entertainer
Frontdesk/Reception
Management
IT/Tech Support
Utility/Maintenance
How many hours do you typically work per week?
20 hours or less
20-30 hours
30-40 hours
40 + hours a week
3. Physical Health
What are the biggest physical challenges you face in your job? (Select all that apply)
Long hours on feet
Heavy lifting
Repetitive Motion
Postural Issues
Foot/leg/knee pain
Back/shoulder pain
Other -- Please Specify:
How often do you experience physical discomfort or pain due to your job?
Never
Rarely
Sometimes
Often
Always
4. Mental Health
How often do you feel stressed or burned out due to your job?
Never
Rarely
Sometimes
Often
Always
What mental health challenges do you face in your job? (Select all that apply)
High Stress
Irregular/long Hours
Limited time for self-care
substance use/dependency issues
Other -- Please Specify:
What mental health challenges do you face in your home life that may affect your job? (Select all that apply)
Anxiety/Depression/Diagnosed mental health issues
Issues with healthy eating/nutrition
chaotic home-life/unstable living circumstances
Receiving steady child-care
None/Prefer not to say
Other -- Please Specify:
5. Fitness & Wellness Preferences
What types of fitness activities are you interested in? (Select all that apply)
Strength Training
Flexibility & Mobility Exercises (e.g., Yoga)
Cardio Workouts
Postural Alignment Exercises
Other -- Please Specify:
How much time do you have to dedicate to exercising?
5-10 Minutes a day
15-30 minutes a day
An hour or more
I can dedicate a few hours a day to a good exercise routine
When would you prefer to incorporate exercise into your day as a Hospitality worker? (Select all that apply)
Before my shift/Mornings
After my shift/Evenings
I can dedicate some time during my shift or break for some quick exercises and stretches
On my days off
What wellness topics would you like to learn more about? (Select all that apply)
Stress management
Nutrition and meal planning
Sleep hygiene
work-life balance
substance use support
Other -- Please Specify:
6. Additional Comments: Do you have any additional comments or suggestions for our wellness program? Please share any information, ideas, suggestions or anything you'd like to add!
Submit
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