HII: I Want To Make A Change But... Registration

I Want To Make A Change But...

REGISTRATION
Thanks for your interest in our monthly video program. I Want To Make A Change But... provides helpful tips and tools via video to help you address barriers to healthier living.

Live programs take place on the first Wednesday of the month. These programs will be emailed out on the following Friday to subscribers and available on demand on the BeWell for Life I Want To Make A Change But... program page.

Please complete the form provided below to subscribe to the monthly video tips.
Location or Work Group*
Work Type*
Age

18-3031-4041-5051-6060+
Name*

First NameLast Name
Email*
example@example.com
Tell Us More About Yourself To help us better meet your needs and provide useful information to our audience, we invite you to complete this short survey.
Are you considering making a change to adopt a more healthy lifestyle habit?*

YesNoSort of
Please choose the area(s) you are considering making a change in:*

Exercise (increase, start, switch it up!)Healthy eatingManaging your stress; finding new coping strategiesWeight management
Select any barriers hindering or preventing you from making the change:*

I don’t know where to startI don’t have timeI don’t have support of family/friendsIt costs too muchI don’t have access to the resources I need to make the changeI’m not motivated/I can’t stay motivatedI’m not sure I’ll be successfulI don’t really know what the change will look like/no clear goalOther
In what areas are you currently considering making a change?*
Are you interested in working with a health coach or registered dietitian nutritionist (RDN) to overcome your barrier and make a healthy change?*

YesNoI'm already working with a coach/registered dietitian (RDN)
How did you hear about the program? Select all that apply.*

BeWell Bulletin monthly newsletterDepartment meetingsDigital monitorsEmailEventMobile apps (Ingalls Connect, HII TechKnow, NNS to Go)my.HII.com/HIIbenefits.comMy leadermyquadmed.com/bewellNutrition Bytes monthly newsletterPostal mailPosterQuadMed provider/wellness coach/RDNWellness OnlineWord of mouthOther
BeWell for Life wellness services are available to all HII employees, regardless of medical coverage. Some services may be limited to the HII Family Health Center or online.
Should be Empty: