Pre Assessment RS5K

Pre Assessment Participant Survey

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About you

NUID*

KP National User ID (NUID) for employees

Name*

First

Middle

Last

Suffix

Email address*

Facility*

Department*

RS5K assessment

Please let us know where you would prefer to participate:

How many days a week do you spend 30 minutes or more walking or doing other forms of moderate to vigorous exercise outside of work?*

Days

What are the main barriers that keep you from walking or doing cardiovascular exercise?*

This field should be left blank