PHW Health Survey
This survey is meant to help us understand your experiences so that we can best utilize Partners in Health and Wholeness resources to contribute to the health and well being of your congregation. THERE ARE NO RIGHT OR WRONG ANSWERS. Your responses will remain completely anonymous. you will not be asked to provide your name or any other identifying information.
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Name of Congregation *
Partners in Health and Wholeness connects health and faith. How important is it to you that the faith community provides health information through a faith lens to congregants?
Not very important
Very important
Clear selection
How nutritious do you think your daily meals are?
Not at all nutritious mainly eat things that are processed
very nutritious mainly fresh fruits and veggies
Clear selection
If you think that your meals are not as nutritious as you would like them to be what barriers do you face? What kind of support would be helpful to you?
Which of the following best describes your personal experience with nicotine delivery products? ie vapes, cigarettes, chewing tobacco  
Clear selection
Rank these topics from most important to least important to you (6 being most important and 1 being least important)
1
2
3
4
5
6
Healthy Aging
Nutrition
Exercise
Mental health
Substance use
Smoking cessation
Clear selection
Which of the following would you like to see your faith community do? (choose all that apply)
Clear selection
How do you define community health?
What words best describe your community?
Are you the health lead for your faith community? (The health lead is the contact person at your congregation that is part of the health ministry who is dedicated to completing form submissions and maintaining the relationship with Partners of Health and Wholeness.
Clear selection
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