Let's Get Moving - Starting Line Survey

Question Title

* 1. On average, how much moderate level activity do you think you do each week?
Moderate level activity will raise your heart rate, make you breathe faster and feel warmer. This can include activities such as housework, gardening and walking.

I am active for 29 minutes or less per week

I am active for 30 to 59 minutes per week

I am active for 1 – 2 hours 29 minutes per week

I am active for 2 hours 30 minutes or more per week

Question Title

* 2. What are you hoping to gain by taking part in the Let’s Get Moving challenge? (Please choose all that apply)

Feel fitter

Lose weight

Help build and strengthen muscles

Help with balance and coordination

Other (Please tell us about the 'Other' in the box below)

About you (optional)

We are asking for this information so we can assess responses by different population groups and see how the characteristics of survey respondents compare to those of the borough population as a whole.

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* 3. Are you?

Male

Female

Prefer to identify myself as (Please enter in the box below)

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* 4. In what year were you born? (Please click in the box below to select year)

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* 5. What is your ethnic group?

Asian

Black

Mixed or Multiple ethnic groups

White

Other

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* 6. Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more that reduce your ability to carry out day-to-day activities?

Yes

Thank you for taking the time to complete this survey.

For tips on moving more please visit www.lets-get.com/move

You can find Dudley Council’s Privacy and Disclaimer Statements here.

Please click the "DONE" button to finish.

Let's Get Moving - Starting Line Survey

Question Title

* 1. On average, how much moderate level activity do you think you do each week?Moderate level activity will raise your heart rate, make you breathe faster and feel warmer. This can include activities such as housework, gardening and walking.

Question Title

* 2. What are you hoping to gain by taking part in the Let’s Get Moving challenge? (Please choose all that apply)

Question Title

* 3. Are you?

Question Title

* 4. In what year were you born? (Please click in the box below to select year)

Question Title

* 5. What is your ethnic group?

Question Title

* 6. Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more that reduce your ability to carry out day-to-day activities?

* 1. On average, how much moderate level activity do you think you do each week?
Moderate level activity will raise your heart rate, make you breathe faster and feel warmer. This can include activities such as housework, gardening and walking.