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Employee Wellness Program Health Risk Survey - Free Healthcare Template | ZenBuild | ZenBuild

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Employee Wellness Program Health Risk Survey

Assess employee health risks and wellness needs to personalize workplace wellness program offerings.

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Employee Wellness Program Health Risk Survey

Assess employee health risks and wellness needs to personalize workplace wellness program offerings.

Employee Name

Department*

Age Range*

How Would You Rate Your Overall Health?*

ExcellentGoodFairPoor

Health Conditions You Are Managing

High blood pressureDiabetesHigh cholesterolObesityAnxiety/depressionBack/joint painNone

Wellness Topics You Are Interested In*

Nutrition and dietPhysical activityStress managementSleep improvementFinancial wellnessSmoking cessationMental health support

Do You Currently Exercise Regularly?*

Yes (3+ times/week)Sometimes (1-2 times/week)RarelyNever

What Would Encourage You to Participate More in Wellness Programs?

Template Details

CategoryHealthcare

IndustryHealthcare

Fields8

Uses0

Views2

employee wellnesshealth risksurveyworkplace health