NEC Health Survey | Students, Fall 2018
Help us improve our performance health offerings at NEC by completing this brief survey (5 minutes to complete + opportunity to win one of two $25 Amazon Gift Cards).

This is an anonymous survey. Results will be reported in aggregate and de-identified.

Student Status *
Area of Focus *
Personal History of Performance Related Injury? *
If you answered "Unsure" in the previous question, please explain:
Your answer
If you answered "Yes" in the previous question, how has this injury affected your music making?
Your answer
I have experienced performance-related pain / discomfort / injury, etc. while at NEC: *
Rarely
Very Often
I have reported performance-related pain / discomfort / injury, etc. to NEC Faculty while at NEC: *
Rarely
Very Often
I am aware of referral resources at NEC for performance-related pain / discomfort / injury, etc: *
If you responded "Other" in the previous question, please explain:
Your answer
Which symptoms have affected your performance or ability to practice? (check all that apply)
Head/Neck:
Upper Extremity:
Lower Extremity:
Spine:
Neurological:
Psychological:
If you responded "Other" in the previous question, please explain:
Your answer
Have you used drugs, alcohol, or other substances to manage performance related discomfort, pain, or anxiety? *
I am most apt to seek further evaluation from a health-care provider, if: (check all that apply) *
Required
If you responded "other" in the previous question, please explain:
Your answer
I am aware NEC offers performance health-related courses, programming, and services: *
I would like NEC to have more health-related programming and services on NEC Campus: *
If you responded "Yes" in the previous question, please provide suggestions for health-related courses/programming/services:
Your answer
I am aware the NEC Health & Counseling Center evaluates and treats performance-related pain, injuries, and performance related anxiety: *
I think NEC offers performance health related programming, courses, and services that meet my needs: *
Strongly Disagree
Strongly Agree
Would you like to share any other information related to performance health at NEC?
Your answer
If you are interested in entering the drawing (two $25 Amazon Gift Cards!) for completing this survey, please provide your email below (your email will be de-identified prior to collecting survey results) :
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service