Professional Documents
Culture Documents
Other _____________________________
11. Do you have a health care provider (Doctor, Nurse Practitioner, etc)? 1-
Yes 0-No
Name or
Location:________________________________________________________________
Resource Referral List
12. What would you be interested in participating in any of the following
programs?
1-Healthy Living 2-Exercise / weight lifting 3-Healthy Eating/Weight Loss
4-Having a Health Advocate (For those with a Chronic Illness) 5-Being a Health
Advocate
6-Other:______________________________________________________________
13. Are you interested in purchasing fresh produce in your neighborhood if
EBT is accepted?
1-Yes 2-No Name of your
neighborhood:______________________________
14. Would you like to hear about upcoming events related to Healthy
Columbia? 1-Yes 0-No