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Questions marked with a * are required Exit Survey
 
 

This Questionnaire shall capture your Body Mindfullness.
In the following you will find statements about your physical condition.
Please rank yourself in the following scales and mark each question with a „X“. Choose the one that best represtents your current state. Please provide the most honest answer possible, without overthinking (your inital thought). There are no „right“ or „wrong, no „good“ or „bad“ answers. Your personal experience is the most important.

Thank you for your paticipation!
 
 
 
Gender
 
Male
 
Female
 
 
* Age
 
16-25
 
26-40
 
41-60
 
60+
 
 
Do you have any physical impairments?
   
 
 
* Do you practice Mindfulness/Meditation?
 
Yes
 
No
 
Sometimes
 
 
* Do you practice Yoga, Dancing, ... ?
 
Yes
 
No
 
Sometimes
 
 
 
* I can appreciate myself and my body.
 
Never or very rarely true
 
Sometimes true
 
Often true
 
Very often or always true
 
 
 
* I am feeling physically active.
 
Never or very rarely true
 
Sometimes true
 
Often true
 
Very often or always true
 
 
 
* I like doing healthy things to my body.
 
Never or very rarely true
 
Sometimes true
 
Often true
 
Very often or always true
 
 
 
* My body is a burden to me.
 
Never or very rarely true
 
Sometimes true
 
Often true
 
Very often or always true