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Body Literacy Group Questionnaire
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* Indicates required question
What makes someone a good friend? (check all that apply)
*
They like doing the same things you like to do.
They listen to you when you're feeling bad or confused.
They do things to help you out.
You can count on them to keep their word.
You can count on them to never speak bad about you behind your back.
You can talk about anything that's on your mind with them without fear that they will make fun of you.
They're honest with you even when it's hard to hear.
They speak kindly to you.
They make you laugh.
They celebrate your accomplishments with you.
They inspire you and help you grow as a person.
Other:
Required
If your friend asks you why you did something, how do you tend to respond? (check all that apply)
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Defensively - isn't it obvious? Who are they to question you?
With resignation and shame - it must have been a stupid decision if they're asking you about it.
With curiosity and introspection - how could that action have looked from a different perspective? What were you actually thinking and feeling when you made that decision? Could it have been a conditioned reaction that you learned in the past but might not be serving you now?
Other:
Required
How do you usually behave in a group setting? (check all that apply)
*
I'm quiet and shy, at least until I get to know people.
I'm friendly and outgoing - I like to make people feel welcome.
I'm loud and take charge.
It's hard for me to focus.
I feel comfortable being quiet or speaking up as appropriate.
Other:
Required
What helps you learn something new? (check all that apply)
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Clear spoken explanation
Clear written explanation
Watching the skill demonstrated and visual aids
Practice, practice, practice
Being able to ask questions and get thoughtful feedback
Positive encouragement
I don't know how to learn.
Other:
Required
Are you willing and interested in following these ground rules of a group you join: 1) Maintain confidentiality. 2) Be kind. 3) Practice active listening.
*
Yes, absolutely.
No. I have a problem with... (please explain in "other" section)
Maybe. I'd like to learn more about what these rules mean before I agree to them. (please explain in "other" section)
Other:
Required
I'm interested in joining the following group(s): (check all that apply)
In-person Body Literate Men's Group starting May 2, 2022
In-person Body Literate Men's Group starting sometime in the future
In-person Body Literate Friend's Group (all genders) starting sometime in the future
Online Body Literate Friend's Group (all genders) starting sometime in the future
Online Body Literate Men's Group starting sometime in the future
Weekend retreat Body Literacy 101 in or near Olympia, WA
Weekend retreat Body Literacy 101 in or near Seattle, WA
Weekend retreat Body Literacy 101 in or near Boston, MA
None. Groups are lame.
Other:
How do you like to be known? Name, nickname, pronouns, etc.
Your answer
What's the best phone number to reach you at?
Your answer
What's your email address?
Your answer
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