Home pack review

This short questionnaire is to help us see if Active Communities is making a difference to you and your community. Below are questions about your activity and sitting behaviour. PLEASE TICK ONE BOX FOR EACH QUESTION UNLESS OTHERWISE INDICATED.

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* 1. Which community organisation are you linked with?

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* 2. What is your home post code?

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* 3. I do 30 minutes moderate physical activity 5 days a week(e.g. activity that raises my heart rate or leaves me breathless so I can talk but not sing).  (Tick one only)

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* 4. I spend more of my day sitting down than standing and moving  (Tick one only.)

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* 5. I can only sit, but I move my arms or legs or upper body when I can (Only tick if appropriate)

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* 6. I use simple ways every day to sit less, stand often and move more (e.g. standing phone calls, taking the stairs, parking further away from my destination etc.) (Tick one only.)

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* 7. Please tell us other options you use to sit less and move more each day.

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* 8. I am (Tick one only)

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* 9. I am (Tick one only)

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* 10. I am (Tick one only)

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* 11. I've heard of Active Communities from (Tick one only)

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