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Q-Active Class Questionnaire

THIS QUESTIONNAIRE IS NOW CLOSED

1. Gender:
Male
Female

2. Year of Birth (e.g. 1960):


3. Home Postcode:


4. What is your ethnic origin?
White British/Irish or other Mixed white / Black Caribbean Mixed white / Black African Mixed white / Asian Mixed other Asian Indian Asian Pakistan Asian Bangladeshi Asian other Black Caribbean Black African Black other Chinese Other Do not wish to state

5. Staff Group:
Admin & Clerical / Senior Managers AHP Ancillary Dental Maintenance Scientific :amp; Professional Medical Nursing Technician

6. Do you work full time or part-time?
Full time
Part-time

7. Do you work shifts?
Yes
No

8. Is your general health
Very good Good Fair Poor

9. If you have recently attended a class, what was it called?
(if not, skip to question 19)


10. Was this your first Q-Active class?
Yes No

11. If not, how many classes do you attend in an average week?
1 2 3 4+

12. Did you enjoy the class?
Yes No

13. Did this class (please tick all that apply)
Relax you? Make you feel fitter?
Improve your mood? Make you feel healthy?
Introduce you to new people? None of these

14. Was the instructor:
Excellent Good Average Poor Very Poor

15. Was the class at a good time of day for you?
Yes No If no, what time of day would be better?

16. How did you hear about Q-Active classes?
NUHorizons Notice Board Evening Post NUH Intranet Colleague Television news Q-active website Promotional activity in canteen Other

17. Do you intend to continue attending Q-active classes over the next:
As long as they`re running As long as I work here 1 Month 1 - 3 months 3 - 6 months 6 - 12 months I do not intend to continue

18. Have you attended any other Q-Active classes? (please tick all that apply)
Yoga Fitness Pilates
Nordic Walking Bums, legs & Tums
Salsa dancing Belly dancing
Circuit Training
If not, why?

19. Are there any other classes you would like us to put on? (please tick all that apply)
Ab blast Martial arts Running
Other...

20. Do you have any other suggestions for future activities/programmes?

Thank-you for completing this questionnaire. Please press the submit button to send your responses.