About this template
This Research Questionnaire is designed for academic investigators, health researchers, and institutional studies focusing on the intersection of aging, physical inactivity, and chronic health conditions among organizational leaders. The questionnaire captures comprehensive demographic details, leadership duties, medical history including chronic illnesses and sleep problems, and daily physical activity or exercise habits.
Researchers use this structured template to gather quantitative and qualitative data on how lifestyle factors and physical exertion impact leadership performance and overall wellness. By collecting standardized responses, investigators can easily analyze correlations between sedentary workloads and health outcomes.
With Doc2Form, you can instantly turn this structured questionnaire into a ready-to-use Google Form, allowing you to seamlessly collect secure participant responses and export data for advanced statistical analysis.
Key features
- Comprehensive sections covering demographics, medical history, and exercise habits
- Built-in rating scales for evaluating physical activity and sports participation
- Pre-configured text fields for detailed medical conditions and lifestyle factors
- Easily export responses into Google Sheets for instant data analysis
- Fully customizable to fit specific institutional review board (IRB) or study requirements
Use cases
Academic studies on the health impacts of sedentary leadership roles
Clinical research examining physical inactivity and aging-related ill…
Clinical research examining physical inactivity and aging-related illnesses
Corporate wellness assessments evaluating executive health and stress…
Corporate wellness assessments evaluating executive health and stress levels
Public health surveys on exercise habits and cardiovascular health
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)Provide a preferred email address for follow-up communications if required.
- Phone Number (Short answer)Include your area code.
- Age (Short answer)Enter your age in years.
- Gender (Multiple choice)Select your gender identity.
- Occupation & Leadership Role (Paragraph)Describe your current occupation and your primary leadership responsibilities.
- Weekly Leadership Duty Hours (Multiple choice)Select the option that best reflects your average weekly hours dedicated to leadership duties.
- Medical History: Blood Pressure (Multiple choice)Have you been diagnosed with or treated for high blood pressure?
- Medical History: Cardiovascular Problems (Multiple choice)Have you experienced any cardiovascular or heart-related issues?
- Medical History: High Cholesterol (Multiple choice)Have you been diagnosed with high cholesterol levels?
- Medical History: Diabetes (Multiple choice)Do you manage diabetes (Type 1 or Type 2)?
- Medical History: Sleep Problems (Multiple choice)Do you regularly experience sleep disorders, insomnia, or poor sleep quality?
- Medical History: Arthritis or Orthopedic Conditions (Multiple choice)Do you suffer from arthritis or any chronic orthopedic illness restricting movement?
- Other Medical Conditions (Paragraph)Please list any other significant medical conditions or note if none.
- Prescription Medication & Supplement Use (Multiple choice)Do you regularly take prescription medications or dietary supplements?
- Weekly Exercise Days (Dropdown)How many days per week do you engage in deliberate physical exercise or sports?
- Daily Exercise Duration (Dropdown)On days when you exercise, what is your average duration in minutes?
- Barriers to Physical Activity (Multiple choice)Is a busy schedule your primary barrier to maintaining regular physical activity?
- Importance of Sports & Exercise to Leadership (Linear scale)Rate the importance of sports and physical activity in maintaining your leadership effectiveness.
- Further Comments or Suggestions (Paragraph)Please share any additional insights regarding physical activity, aging, and leadership performance.
FAQ
How can I customize this research questionnaire for my study?
Once the template is loaded into your Google Account, you can easily add, remove, or edit questions to match your specific study parameters and institutional guidelines.
Where are the questionnaire responses stored?
All participant submissions are securely saved in a connected Google Sheet owned by you, making it simple to organize, filter, and export data for statistical analysis.
Can I share this questionnaire with participants online?
Yes. You can share the Google Form via a direct link, embed it on a study website, or distribute it via email to your target participant group.
Is this template suitable for institutional research boards (IRB)?
While the template provides the structural questions for health and lifestyle research, you should ensure your final form complies with your institution's specific ethical and informed consent standards.
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