Thank you for taking part in our survey of people who participate in the Feldenkrais Method
The survey should only take a few minutes.
SURVEY OF
CLIENTS AND STUDENTS
1. Are you attending?
1 Awareness Through Movement (ATM) group class
2 Functional Integration (FI) one on one lessons
2. Are you?
1 Male
2 Female
3. What age bracket are you in?
0-14
15-24
25-34
35-44
45-54
55-64
65+
4. Which best describes your employment status? You may have more than one answer
Working, please state what job sector below
Pensioner/retired
Student
Home maker
Unemployed
Other (Please give details below
If you selected 'working' or 'other', please give details
5. Which of the following best describes your household income before taxes? Please select one answer. Please note that it is optional to complete this question.
1. Under $50.000
2. $51.000 to $99.999
3. Over $100.000
I'd rather not say
6. Where do you live? Please select one answer
New South Wales/ACT
Queensland
South Australia
Tasmania
Victoria
Western Australia
7. How would you describe The Feldenkrais Method to someone?
8. Where did you first hear about the Feldenkrais Method?
1 Internet
2 Recommended/referred by medical practitioner
3 Word of mouth
4 Advertising
5 Facebook
6 Read in a book
7 Website
98 Other please specify below
97 Don't know, can't remember
If 'other' please specify:
9. We are interested in why you attend. Please select one or many of these possibilities -
1 Rehabilitation from injury
2 Improve flexibility and mobility
3. Rehabilitation from surgery
4. Awakens the brain and improves intelligence
5. Pain relief (e.g headaches, back pain, scoliosis, arthritis)
6. Living difficulties (e.g stroke, brain injury, MS, autism, cerebral palsy, or other medical condition)
7. Vitality and increased energy
8. Prevention or relief of stiffness
9. Improved performance
10. Loss of memory (e.g dementia)
11. Learning difficulties/ poor attention
12. Posture, balance and co-ordination
97. Don't know
98. Other, please specify below
If 'Other' please specify
10. How has the Feldenkrais Method impacted your life?
Submit
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