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Pre-Survey for Yoga Therapy for Fall Prevention & Injury Reduction
Online 4-Week Workshop series hosted and funded by the Ukrainian Canadian Care Centre
Dates: Fridays November 5, 12, 19, 26
Time: 11am-12:30pm
Platform: Zoom
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The following questions will be used as a quality of life comparison to the same questions being asked to you after the 4 week series. This form does not collect any identifying data (ie: name, email etc–it is completely anonymous) but the survey results may be used to inform future program development.
How afraid are you of falls?
Not at all afraid
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10
It gets in the way of me living the life I want to live
Clear selection
How often do you avoid going out because of fear of falling?
None of the time
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10
All of the time
Clear selection
I feel that I understand how to train my balance (other than just trying to stand on one leg)
No idea!
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10
I feel very confident in my understanding of how to train my balance
Clear selection
I have a sense of where my mobility concerns affect my balance.
No idea!
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10
I know where I need to improve my mobility
Clear selection
I have plans for how to get up if I ever do fall
No plans
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10
I have a plan (or multiple plans)
Clear selection
Do you have any specific questions for that you would like Kassandra to address in the series if it is within the scope of practice of a yoga therapist?
Your answer
Anything else you'd like to ask or share?
Your answer
Thank you! Please log onto the class with the same information as the other drop-in programs:
Zoom Meeting ID: 883 2094 8826 | Password: uccc
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