Debra's Healing Kitchen
Welcome
DHK Podcast
Testimonials
DHK WELLNESS
Store
About
COVID-2020
Contact
Resources
How To Get Started
Dish On Health
Healthy Tips
Videos
Photo Gallery
Previous Events
Recipes
Fish Tacos
Veggie Stir Fry
A CONVERSATION WITH DR. JEWEL POOKRUM
SURVEY
Introduction:
Thank you for your participation. This survey is designed to collect data that will ultimately assist those who want to better their overall health as well as help us improve future events to better serve our participants. This survey is anonymous and confidential, so please reply to each question as honestly as possible.
Disclaimer:
All information and results related to this survey is for informational purposes only. The information presented is not collected for specific medical advice for any individual. The content of this survey should not substitute for medical advice from a certified health professional. If you have a health problem, speak to your doctor or a healthcare professional immediately about your concerns.
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Indicates required field
1. What is the current state of your overall health?
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Excellent
Good
Fair
Poor
2. Do you have high blood pressure (HBP)?
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Yes
No
If yes, do you take medication(s) for HBP?
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Yes
No
3. Do you suffer from fibroids or endometriosis?
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Yes
No
4. Do you eat fast food weekly?
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Yes
No
5. What is your greatest concern regarding your health?
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6. What type of wellness class would you like to see presented?
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7. How did you hear about this event?
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Radio
Church Announcement
Email Promotion
At Another Event
A Friend
Social Media (Facebook, Twitter, etc.)
Other
8. How would you rate the overall event?
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Excellent
Good
Fair
Poor
9. How would you rate our Featured Speaker?
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Excellent
Good
Fair
Poor
10. How would you rate the material presented?
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Excellent
Good
Fair
Poor
11. How did you like the Cooking Demonstration/Food Tasting?
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Excellent
Good
Fair
Poor
12. Would you recommend this event to a friend?
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Yes
No
13. Did you find the information presented helpful?
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Yes
No
If yes, are you willing to make changes for your health?
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Yes
No
14. What did you learn from this event that would be beneficial to your health?
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15. What did you enjoy most about this event?
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Please click on the SUBMIT button below to complete this survey. You will receive a message if a required field was not completed. Otherwise, you will receive a confirmation message that your information was submitted.
Submit
Welcome
DHK Podcast
Testimonials
DHK WELLNESS
Store
About
COVID-2020
Contact
Resources
How To Get Started
Dish On Health
Healthy Tips
Videos
Photo Gallery
Previous Events
Recipes
Fish Tacos
Veggie Stir Fry