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Bates Family Health Challenge Weekly Fitness Survey
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* Indicates required question
Survey Week (Sunday-Saturday)
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You should submit your results by noon on Sunday for the previous week. Please enter the Sunday date of the week as MM-DD-YY.
Your answer
Challenger Member Name
*
Choose
Bates, G.
Bates, J.
Bates-Gomez, C.
Bates-Gomez, W.
Middleton, J.
Middleton, M.
Rankins, L.
Walker, C.
Walker, W.
Did you eat AT LEAST two lunch or dinner meals without meat this week?
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Yes
No
Did you work out for at least 30 minutes 3 days this week?
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Yes
No
Did you limit your television watching to LESS THAN 2 hours each day this week?
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Yes
No
Did you limit your sodium and sugar this week?
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Yes
No
Did you drink AT LEAST 11 cups of water each day this week?
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Yes
No
Which challenge goal presented you with the MOST difficulty this week?
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Get Veggies
Get Fit
Get Moving
Get Heart Smart
Get Hydrated
In which challenge area could you use more support, guidance or tips?
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Get Veggies
Get Fit
Get Moving
Get Heart Smart
Get Hydrated
Anything else?
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