Community Health Wave 4 Survey Screenshots

Attachment 5c: Representative Screenshots of Online Screener and Survey for
Wave 4: Healthy Living
Screenshot – Online Screener Home Page

1

Screenshot – Online Screener Question S1

2

Screenshot – Online Screener Question S2

3

Screenshot – Online Screener Question S3

4

Screenshot – Online Screener Question S4

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Screenshot – Online Screener Question S5

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Screenshot – Online Screener Question S6

7

Screenshot – Online Survey Home Page

8

Screenshot – Online Survey Question Q1

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Screenshot – Online Survey Question Q 1_1

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Screenshot – Online Survey Question Q 1_2

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Screenshot – Online Survey Question Q 1_3

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Screenshot – Online Survey Question Q 2

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Screenshot – Online Survey Question Q 11

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Screenshot – Online Survey Ad Viewing Screen

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Screenshot – Online Survey Transition Screen

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Screenshot – Online Survey Question Q12

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Screenshot – Online Survey Question Q13

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Screenshot – Online Survey Question Q14

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Screenshot – Online Survey Question Q15

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Screenshot – Online Survey Question Q16: Wave 4

21

Screenshot – Online Survey Completion Screen

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