Parish Health and Wellness Committee Needs Assessment Survey*

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The Health and Wellness Committee of our parish is dedicated to promoting the well-being of our parishioners. To better understand your needs and interests, we invite you to complete this brief and confidential survey. We are committed to serving the needs of our parishioners, and your input will help guide us in providing the most valuable resources and programs in the future.

Age Group: *

Under 18

18-29

30-49

50-64

65 +

Required

Do you have a primary care provider

Yes

I use urgent care when I need it

Clear selection

What health and wellness topics are most important to you or your family? *

Mental health and stress management

Nutrition and healthy eating

Physical fitness and exercise

Chronic disease management (e.g., diabetes, heart disease)

Aging and senior care

Child and adolescent health (e.g., depression, bullying/peer pressure, good nutrition)

Family caregiving support

Substance abuse preventionion

Spiritual health

Other:

Required

What types of programs or activities would you like the committee to offer? *

Health education workshops

Fitness classes (e.g., gentle fitness, walking/running groups)

Support groups (e.g., grief, caregiving)

Health screenings (e.g., blood pressure, cholesterol)

Spiritual wellness retreats or workshops

Community service opportunities

Nutrition workshops

Other:

Required

Are there specific health challenges you or your family face that you would like the Health & Wellness committee to address? *

How often do you feel lonely or isolated?
*

Always

Usually

Sometimes

Rarely

Never

Required

How is your sleep quality most nights?
*

Very Good

Fair

Poor

Very Poor

Required

How often do you feel stressed or overwhelmed by daily responsibilities?
*

Always

Usually

Sometimes

Rarely

Never

Required

In the past month, how often have you felt down, depressed, or hopeless?
*

Always

Usually

Sometimes

Rarely

Never

Required

In general, how would you rate your overall mental or emotional health? *

Excellent

Good

Fair

Poor

Required

How much support do you feel you have from friends, family or community?
*

A great deal

A moderate amount

A little

None

Required

What kind of mental or emotional support programs would you like to see at the parish?

Would you be interested in programs that manage stress through prayer, scripture, and spiritual practices? *

Yes

Maybe

Required

Prayer is an important part of many people’s lives. How often do you find yourself turning to prayer?

Throughout the day

Daily

A few times a week

From time to time

Not often, but open to it

Clear selection

During Mass, how confident do you feel in understanding what is happening on the Altar and the meaning?

I usually understand and follow along well

I understand some parts, but not everything

I often feel unsure about what’s happening

I would like to learn more about the meaning of the Mass

Clear selection

What would help you feel more spiritually nourished and supported by your parish

What times would be most convenient for you to attend health and wellness events? Select all that apply
*

Morning

Afternoon

Evening

Weekends

Do you have any additional suggestions or comments for the Health and Wellness Committee?

Would you be interested in volunteering with the Health and Wellness Committee?
*

Yes, I’m interested in volunteering.

If interested please provide name, phone number, and email :

No, but I’d like to participate in activities.

Required

If yes, please share any skills or experience you could bring to the committee:

Submit

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