Preble Arts - Revitalizing First Responders
Pre-Program Survey
The purpose of this survey is for internal research only. We are not collecting any personal data. Please answer all questions to the best of your knowledge. This survey is intended to help us better serve you.
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What is your gender? *
What is your age? *
Are you now married, widowed, divorced, separated, or have you never been married? *
Field of Work/ Occupation: *
Do you have children? If yes, how many? If no, leave blank.
Have you been impacted by the COVID-19 Pandemic? *
Do you or someone you know continue to experience the impact of the pandemic? (financially, emotionally, physically, etc.). *
Do you or someone in your household experience higher than normal levels of stress due to the current demands of your work? *
Have you thought about changing careers/jobs/quitting because of the stressors of your work? *
Has the pandemic impacted your life and the lives of your loved ones? (stress, depression, social isolation, etc.). *
Has the pandemic changed your family dynamics? *
Have you ever practiced any form of art? *
What are mediums are you familiar with?
Do you do any handcrafting? *
Did you know that art can be therapeutic? *
Would you benefit from a program that would help you de-stress and cope with the demands of your work life? *
Would this program help you better perform at work and meet the expectations of your daily work life? *
Would this program help you cope with family demands at home and meet the expectations of your home-life? *
Rate your level of stress 0-5 at work.  0 being not stressed at all, and 5 being extremely stressed. *
Not stressed at all
Extremely stressed
Rate your level of sadness 0-5.  0 being not sad at all, and 5 being extremely sad. *
Not sad at all
Extremely sad
Do you feel you have lost motivation in the last year? *
Do you see yourself as a leader? *
Do you feel like you can speak in a group setting? *
Do you practice any coping skills that help you with stress? If yes, please list activities you practice regularly to deal with stress. If no, leave blank.
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