Congregation Health Survey

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[CHURCH NAME] Health & Wellness Survey
Our church is starting a season of learning what it means to honor God with our whole selves, including our bodies. This survey is anonymous. There are no wrong answers, and no one will follow up with you about what you write.

1. How would you describe your own health right now?
☐ Doing well ☐ Some things I’d like to change ☐ Struggling ☐ Rather not say

2. Which of these would you most like help with? (Check up to three)
☐ Eating better ☐ Cooking at home ☐ Getting active ☐ Sleep ☐ Stress and anxiety ☐ Rest and Sabbath ☐ Food on a budget ☐ Family and kids’ habits ☐ Encouragement and accountability

3. What gets in the way most? (Check up to two)
☐ Time ☐ Cost ☐ Motivation ☐ Not knowing where to start ☐ Health limits ☐ Family or work schedule ☐ Nothing much

4. How many days a week are you active for at least 30 minutes?
☐ 0 ☐ 1–2 ☐ 3–4 ☐ 5+

5. How many meals a week does your household cook at home?
☐ 0–3 ☐ 4–7 ☐ 8–14 ☐ 15+

6. Do you feel rested most weeks? ☐ Yes ☐ Sometimes ☐ No

7. Have you ever thought about your health as part of following Jesus?
☐ Often ☐ Sometimes ☐ Never thought about it that way

8. Which of these would you take part in? (Check all that apply)
☐ A sermon series on the body and food ☐ A small group ☐ A church walking group ☐ A cooking class ☐ A church-wide fast ☐ A 5K or family fun run ☐ Healthier options at church meals ☐ A weekly email tip ☐ Something for my kids

9. When would you most likely take part?
☐ Sunday morning ☐ Sunday evening ☐ A weeknight ☐ Early morning ☐ Saturday ☐ On my own, any time

10. If our church served healthier food at meals and events, how would you feel?
☐ Glad ☐ Fine either way ☐ I’d miss the way it is ☐ Depends on the food

11. Do you have a skill you’d be willing to share? (Check all that apply)
☐ Cooking ☐ Leading a walk or workout ☐ Nursing or medicine ☐ Nutrition ☐ Counseling ☐ Childcare ☐ Organizing ☐ Writing or design

12. Would you be interested in helping with our health team? ☐ Yes ☐ Maybe ☐ No

13. What’s one small change you’d like to make in the next three months?
______________________________________________

14. What could our church do that would actually help you?
______________________________________________

15. Anything you’d like us to pray about? (Leave blank to stay anonymous; add your name if you’d like a call)
______________________________________________

Thank you. “Whether you eat or drink, or whatever you do, do all to the glory of God.” (1 Corinthians 10:31)