Grand Rapids African American Health Institute · Tracking Health with Technology

Tracking Technology

Thank you for taking the first steps in reducing your Stroke and Hypertension risk! Wearable technology has been utilized for decades, and has been revolutionary in how we track our health! In this FREE 8-week program, all participants will receive a FREE smart device and learn how it works with your smart phone. These tools will track daily progress towards a healthier lifestyle, all to prevent Stroke and Hypertension. This comprehensive course will be led by GRAAHI and the GRBNA to walk you through stroke education, fitness, stress management, and more.

EACH CLASS WILL HAVE A MAXIMUM CAPACITY OF 15 PARTICIPANTS, ALL SUBMISSIONS WILL BE HANDLED ON A FIRST COME FIRST SERVE BASIS. Upon completion of this form, the GRAAHI Program Lead will reach out via email/phone confirming your spot in this course. Upon completion of course, you will receive a GRAAHI WELLNESS ACADEMY Certificate.

Program Details:

Location: Lifequest Ministries (1115 Alto Ave SE, Grand Rapids, MI 49507)

Start Date: Wednesday, April 10th, 2024 (Class meets EVERY Wednesday for 8 weeks)

Time: 5:30PM - 7:00PM

If you have any questions, feel free to email calvin.nguyen@graahi.org

Name

First Name

Last Name

Verify Email

Zip Code

Phone

What is Your Age?

What is your Gender?

Male

Female

Non-binary

Transgender Man

Transgender Woman

I prefer not to disclose

Other:

What is your race? (Please select ALL that apply)

American Indian or Native Alaskan

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Multiracial

Prefer not to say

Ethnicity

Hispanic

Non-Hispanic

Are you predisposed or have you been diagnosed with any of the following chronic diseases?

HTN

Diabetes

Kidney/Heart Disease

High Cholesterol

Other

Are you taking prescribed medications?

Yes

Choose not to answer

On average, how many minutes a week do you exercise weekly?

30 Minutes or Less

30 - 60 Minutes

60 - 90 Minutes

90 - 120 Minutes

120 - 150 Minutes

150 + minutes

How often do you track your caloric intake?

Not at all

Daily

Weekly

Monthly

On average, how many days do you meal prep weekly?

1-3

3-4

On a scale from 1-5, how confident are you in preparing a balanced meal?

1 (Not confident)

2 (Somewhat confident)

3 (Neutral)

4 (Confident)

5 (Very Confident)

On average, how many hours do you sleep each night?

5 hrs or less

6 - 7 hrs

8 or more

On a scale from 1 -5, how comfortable are you navigating a smart device?

1 (Not confident)

2 (Somewhat confident)

3 (Neutral)

4 (Confident)

5 (Very Confident)

Do you currently have a primary care medical provider?

Yes

I need one.

Is there anything else you would like to share with us in preparation for the courses?