Keys to Embracing Aging Evaluation As a participant of the Keys to Embracing Aging program, we would appreciate your feedback. Please take a moment to complete this survey. As a result of this program, do you have a better understanding of how the choices you make today affect your health and well-being in the future? No □ Yes □ As a result of this program, do you better understand how various life style choices affect each other and why is it important to practice healthy lifestyle behaviors across multiple domains? (e.g., financial problems affect health status and vice versa.) Yes No □ □ Which of the following healthy lifestyle behavior practices do you currently practice on a regular basis? (check all that apply) Positive Attitude Safety □ □ Eating Smart and Healthy Know Your Health Numbers □ □ Physical Activity Stress Management □ □ Mental Activity Financial Affairs □ □ Social Activity Sleep □ □ Tuning-in to the times Taking Time for You □ □ As a result of this program, which of the healthy lifestyle behaviors do you intend to embrace? (check all that apply) Positive Attitude Safety □ □ Eating Smart and Healthy Know Your Health Numbers □ □ Physical Activity Stress Management □ □ Mental Activity Financial Affairs □ □ Social Activity Sleep □ □ Tuning-in to the times Taking Time for You □ □ Gender: Male Female □ □ Age in years:
Keys to Embracing Aging Evaluation As a participant of the Keys to Embracing Aging program, we would appreciate your feedback. Please take a moment to complete this survey. As a result of this program, do you have a better understanding of how the choices you make today affect your health and well-being in the future? □ Yes □ No As a result of this program, do you better understand how various life style choices affect each other and why is it important to practice healthy lifestyle behaviors across multiple domains? (e.g., financial problems affect health status and vice versa.) □ Yes □ No Which of the following healthy lifestyle behavior practices do you currently practice on a regular basis? (check all that apply) □ Positive Attitude □ Eating Smart and Healthy □ Physical Activity □ Mental Activity □ Social Activity □ Tuning-in to the times □ Safety □ Know Your Health Numbers □ Stress Management □ Financial Affairs □ Sleep □ Taking Time for You As a result of this program, which of the healthy lifestyle behaviors do you intend to embrace? (check all that apply) □ Positive Attitude □ Eating Smart and Healthy □ Physical Activity □ Mental Activity □ Social Activity □ Tuning-in to the times □ Safety □ Know Your Health Numbers □ Stress Management □ Financial Affairs □ Sleep □ Taking Time for You Gender: □ Male □ Female Age in years: