SHC Wellness Survey
Let the SHC team know about your wellness needs, questions, and concerns. By filling out this confidential survey, you will receive an email with personalized feedback, tips, and information about caring for yourself. Chose which information you would like to share with us!
Tell us about yourself! What is your name?
Your answer
Please provide an email where we can send your personalized wellness feedback:
Your answer
Age
Your answer
Height
Your answer
Weight
Your answer
In general, I would say my health is...
Do you suffer from any chronic conditions or disease? Please explain
Your answer
How often do you experience stress and anxiety?
Can you usually pin point where your stress is coming from?
Please indicate which activities you participate in to relieve stress
How many hours of sleep do you usually get a night?
Are you looking to manage any chronic or acute pain?
How often do you drink?
How often do you smoke?
Do you currently take any medications? Please describe
Your answer
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