Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Real Farmer Care Self-Care Survey
Through a collaboration between Real Farmer Care and American Farmland Trust, we are seeking to expand self-care support for farmers and ranchers. To learn more, see our
Oct 21st 2024 Press Release
.
Self-care is generally defined as the practice of taking an active role in protecting one's own well-being and happiness, particularly during periods of stress.
Research shows that higher levels of self-care play a pivotal role in healthier lives and improved longevity. As levels of burnout continue to increase in farmers and ranchers, especially those with marginalized identities, initiatives that financially support farmers and ranchers in taking time to recharge are essential.
If interested in learning more about
applying for a $100 self-care award,
visit
www.RealFarmerCare.com
.
Please fill out this anonymous survey to help us better understand, develop, and offer the most needed self-care support for farmers and ranchers.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Are you or have you ever been a farmer, rancher, and/or farm worker?
*
Farmer
Rancher
Farm Worker
Required
Farm Location
*
Your answer
Total Farm Acres
*
Your answer
Total Acres Cultivated
*
Your answer
Do any of the following growing practices apply? Check all that apply.
*
Organic Certified
Traditional/Conventional
Regenerative
No-Till
Biodynamic
Real Organic Project Certified
Certified Naturally Grown
Other:
Required
What form of self-care do you typically engage in? (If none, indicate n/a):
*
Your answer
From the list of Mental Support Care options, which are or would be the most important to your well-being
as a farmer or rancher
(select more than one and all that apply):
*
Online Talk Therapy
Meditation Instruction
Mindfulness/Stress-Reduction Classes or Apps
Other
Mental Support Care
Online Talk Therapy
Meditation Instruction
Mindfulness/Stress-Reduction Classes or Apps
Other
Mental Support Care
From the list of Body Repair Care options, which are or would be the most important to your well-being
as a farmer or rancher
(select more than one and all that apply):
*
Deep-tissue Massage
Acupuncture
Chiropractic
Other
Body Repair Care
Deep-tissue Massage
Acupuncture
Chiropractic
Other
Body Repair Care
From the list of Body Fitness Care options, which are or would be the most important to your well-being as a farmer or rancher (select more than one and all that apply):
*
Gym Membership
Yoga
Dance
Other
Body Fitness Care
Gym Membership
Yoga
Dance
Other
Body Fitness Care
From the list of Community Support Care options, which are or would be the most important to your well-being
as a farmer or rancher
(select more than one and all that apply):
*
Group Wellness Retreats
Farming/Ranching Knowledge and Support Exchange Program
In-Kind Product Donations, such as seeds, tools, work clothing, footwear, etc.
Other
Community Support Care
Group Wellness Retreats
Farming/Ranching Knowledge and Support Exchange Program
In-Kind Product Donations, such as seeds, tools, work clothing, footwear, etc.
Other
Community Support Care
If you answered 'Other' to any of the Care lists above, please describe what those are:
Your answer
As a farmer or rancher, what does support look like to you? Please describe.
Your answer
How often do you typically engage in a form of self-care?
*
Once per day
Once per week
Once per month
No routine, whenever possible
Never
How often would you like to engage in a form of self-care?
*
Once per day
Once per week
Once per month
No routine, whenever possible
How often do you think other farmers and ranchers practice a form of self-care?
*
Once per day
Once per week
Once per month
No routine, whenever possible
Never
What do you think are the barriers to practicing self-care as a farmer or rancher?
*
Not enough time
Not enough money
Perceived judgment or stigma
Difficult to prioritize
All of the above
As a farmer or rancher, would you prefer to receive self-care support as on-going access to Real Farmer Care programming (such as free online therapy), a direct monetary award of $100 or $500, or both types of support?
*
Access to RFC Programming
Direct Monetary Award
Both types of support
If a direct monetary award, how would you use a $100 self-care award to meet your self-care needs?:
*
Your answer
If a direct monetary award, how would you use a $500 self-care award to meet your self-care needs?:
*
Your answer
Do you qualify as a historically underserved producer as defined by the USDA
?
*
Yes
No
Prefer not to answer
How old are you?
*
18-24
25-34
35-44
45-54
55-64
65 years and over
Prefer not to answer
To which gender identity do you most identify?
*
Male
Female
Transgender
Prefer not to answer
Which racial and ethnic category best describes you?
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic, Latino, or Spanish Origin
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White or European
Prefer not to answer
How do you describe your sexual orientation or sexual identity?
*
Gay
Lesbian
Bisexual
Queer
Gender Queer/Genderfluid
Non-binary
Heterosexual
Prefer not to answer
Other:
Thank you for your answers! Your voice matters and your responses will be helpful in developing self-care support programming for farmers and ranchers.
Would you like to keep in touch with Real Farmer Care and learn about future self-care programing support? If yes, please provide email address below.
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms