Insurance Fitness Program Evaluation
Help us assess and improve our fitness program by sharing your experience and feedback.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is your primary insurance provider?
*
Please Select
ABC Insurance
XYZ Insurance
Other
How long have you been participating in the fitness program?
*
Less than 1 month
1-3 months
4-6 months
More than 6 months
How often do you attend the fitness program sessions?
*
Once a week
2-3 times a week
4 or more times a week
Irregularly
Please rate the following aspects of the program:
*
Rows
Excellent
Good
Average
Poor
Quality of instructors
1
2
3
4
Facilities and equipment
5
6
7
8
Program schedule
9
10
11
12
Communication and support
13
14
15
16
How satisfied are you with your overall experience in the fitness program?
*
1
2
3
4
5
Since joining the program, have you noticed improvements in any of the following areas? (Select all that apply)
*
Physical fitness
Energy levels
Mental well-being
Social connections
None
What motivated you to join the insurance fitness program?
What suggestions do you have to improve the program?
Submit Evaluation
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