Needs Assessment Questionnaire

Thank you for considering Lifelab to enhance your organization's wellness initiatives. This questionnaire is designed to help us understand your company's unique needs and preferences so we can create a customized, world-class corporate wellness program for you.

Please provide as much detail as possible. Your responses will remain confidential and will only be used to tailor our services to your organization.

Company Name*

Industry Type *

Accounting
Airlines/Aviation
Alternative Dispute Resolution
Alternative Medicine
Animation
Apparel & Fashion
Architecture & Planning
Arts and Crafts
Automotive
Aviation & Aerospace
Banking
Biotechnology
Broadcast Media
Building Materials
Business Supplies and Equipment
Capital Markets
Chemicals
Civic & Social Organization
Civil Engineering
Commercial Real Estate
Computer & Network Security
Computer Games
Computer Hardware
Computer Networking
Computer Software
Internet
Construction
Consumer Electronics
Consumer Goods
Consumer Services
Cosmetics
Dairy
Defense & Space
Design
Education Management
E-Learning
Electrical/Electronic Manufacturing
Entertainment
Environmental Services
Events Services
Executive Office
Facilities Services
Farming
Financial Services
Fine Art
Fishery
Food & Beverages
Food Production
Fund-Raising
Furniture
Gambling & Casinos
Glass, Ceramics & Concrete
Government Administration
Government Relations
Graphic Design
Health, Wellness and Fitness
Higher Education
Hospital & Health Care
Hospitality
Human Resources
Import and Export
Individual & Family Services
Industrial Automation
Information Services
Information Technology and Services
Insurance
International Affairs
International Trade and Development
Investment Banking
Investment Management
Judiciary
Law Enforcement
Law Practice
Legal Services
Legislative Office
Leisure, Travel & Tourism
Libraries
Logistics and Supply Chain
Luxury Goods & Jewelry
Machinery
Management Consulting
Maritime
Market Research
Marketing and Advertising
Mechanical or Industrial Engineering
Media Production
Medical Devices
Medical Practice
Mental Health Care
Military
Mining & Metals
Motion Pictures and Film
Museums and Institutions
Music
Nanotechnology
Newspapers
Non-Profit Organization Management
Oil & Energy
Online Media
Outsourcing/Offshoring
Package/Freight Delivery
Packaging and Containers
Paper & Forest Products
Performing Arts
Pharmaceuticals
Philanthropy
Photography
Plastics
Political Organization
Primary/Secondary Education
Printing
Professional Training & Coaching
Program Development
Public Policy
Public Relations and Communications
Public Safety
Publishing
Railroad Manufacture
Ranching
Real Estate
Recreational Facilities and Services
Religious Institutions
Renewables & Environment
Research
Restaurants
Retail
Security and Investigations
Semiconductors
Shipbuilding
Sporting Goods
Sports
Staffing and Recruiting
Supermarkets
Telecommunications
Textiles
Think Tanks
Tobacco
Translation and Localization
Transportation/Trucking/Railroad
Utilities
Venture Capital & Private Equity
Veterinary
Warehousing
Wholesale
Wine and Spirits
Wireless
Writing and Editing
Mobile Games

Location(s)*

Please list all the locations where your company operates. Include city, state/province, and country for each.

Number of Employees*

Total number (including all locations)

1-5
5-25
25-50
50-100
100-500
500-1000
1000+

Primary Contact Person

Name*

Title*

Work Email*

Phone Number*

🇺🇸

🇦🇫 Afghanistan (‫افغانستان‬‎) +93
🇦🇱 Albania (Shqipëri) +355
🇩🇿 Algeria (‫الجزائر‬‎) +213
🇦🇸 American Samoa +1684
🇦🇩 Andorra +376
🇦🇴 Angola +244
🇦🇮 Anguilla +1264
🇦🇬 Antigua and Barbuda +1268
🇦🇷 Argentina +54
🇦🇲 Armenia (Հայաստան) +374
🇦🇼 Aruba +297
🇦🇺 Australia +61
🇦🇹 Austria (Österreich) +43
🇦🇿 Azerbaijan (Azərbaycan) +994
🇧🇸 Bahamas +1242
🇧🇭 Bahrain (‫البحرين‬‎) +973
🇧🇩 Bangladesh (বাংলাদেশ) +880
🇧🇧 Barbados +1246
🇧🇾 Belarus (Беларусь) +375
🇧🇪 Belgium (België) +32
🇧🇿 Belize +501
🇧🇯 Benin (Bénin) +229
🇧🇲 Bermuda +1441
🇧🇹 Bhutan (འབྲུག) +975
🇧🇴 Bolivia +591
🇧🇦 Bosnia and Herzegovina (Босна и Херцеговина) +387
🇧🇼 Botswana +267
🇧🇷 Brazil (Brasil) +55
🇮🇴 British Indian Ocean Territory +246
🇻🇬 British Virgin Islands +1284
🇧🇳 Brunei +673
🇧🇬 Bulgaria (България) +359
🇧🇫 Burkina Faso +226
🇧🇮 Burundi (Uburundi) +257
🇰🇭 Cambodia (កម្ពុជា) +855
🇨🇲 Cameroon (Cameroun) +237
🇨🇦 Canada +1
🇨🇻 Cape Verde (Kabu Verdi) +238
🇧🇶 Caribbean Netherlands +599
🇰🇾 Cayman Islands +1345
🇨🇫 Central African Republic (République centrafricaine) +236
🇹🇩 Chad (Tchad) +235
🇨🇱 Chile +56
🇨🇳 China (中国) +86
🇨🇴 Colombia +57
🇰🇲 Comoros (‫جزر القمر‬‎) +269
🇨🇩 Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo) +243
🇨🇬 Congo (Republic) (Congo-Brazzaville) +242
🇨🇰 Cook Islands +682
🇨🇷 Costa Rica +506
🇨🇮 Côte d’Ivoire +225
🇭🇷 Croatia (Hrvatska) +385
🇨🇺 Cuba +53
🇨🇼 Curaçao +599
🇨🇾 Cyprus (Κύπρος) +357
🇨🇿 Czech Republic (Česká republika) +420
🇩🇰 Denmark (Danmark) +45
🇩🇯 Djibouti +253
🇩🇲 Dominica +1767
🇩🇴 Dominican Republic (República Dominicana) +1
🇪🇨 Ecuador +593
🇪🇬 Egypt (‫مصر‬‎) +20
🇸🇻 El Salvador +503
🇬🇶 Equatorial Guinea (Guinea Ecuatorial) +240
🇪🇷 Eritrea +291
🇪🇪 Estonia (Eesti) +372
🇪🇹 Ethiopia +251
🇫🇰 Falkland Islands (Islas Malvinas) +500
🇫🇴 Faroe Islands (Føroyar) +298
🇫🇯 Fiji +679
🇫🇮 Finland (Suomi) +358
🇫🇷 France +33
🇬🇫 French Guiana (Guyane française) +594
🇵🇫 French Polynesia (Polynésie française) +689
🇬🇦 Gabon +241
🇬🇲 Gambia +220
🇬🇪 Georgia (საქართველო) +995
🇩🇪 Germany (Deutschland) +49
🇬🇭 Ghana (Gaana) +233
🇬🇮 Gibraltar +350
🇬🇷 Greece (Ελλάδα) +30
🇬🇱 Greenland (Kalaallit Nunaat) +299
🇬🇩 Grenada +1473
🇬🇵 Guadeloupe +590
🇬🇺 Guam +1671
🇬🇹 Guatemala +502
🇬🇳 Guinea (Guinée) +224
🇬🇼 Guinea-Bissau (Guiné Bissau) +245
🇬🇾 Guyana +592
🇭🇹 Haiti +509
🇭🇳 Honduras +504
🇭🇰 Hong Kong (香港) +852
🇭🇺 Hungary (Magyarország) +36
🇮🇸 Iceland (Ísland) +354
🇮🇳 India (भारत) +91
🇮🇩 Indonesia +62
🇮🇷 Iran (‫ایران‬‎) +98
🇮🇶 Iraq (‫العراق‬‎) +964
🇮🇪 Ireland +353
🇮🇱 Israel (‫ישראל‬‎) +972
🇮🇹 Italy (Italia) +39
🇯🇲 Jamaica +1876
🇯🇵 Japan (日本) +81
🇯🇴 Jordan (‫الأردن‬‎) +962
🇰🇿 Kazakhstan (Казахстан) +7
🇰🇪 Kenya +254
🇰🇮 Kiribati +686
🇽🇰 Kosovo +383
🇰🇼 Kuwait (‫الكويت‬‎) +965
🇰🇬 Kyrgyzstan (Кыргызстан) +996
🇱🇦 Laos (ລາວ) +856
🇱🇻 Latvia (Latvija) +371
🇱🇧 Lebanon (‫لبنان‬‎) +961
🇱🇸 Lesotho +266
🇱🇷 Liberia +231
🇱🇾 Libya (‫ليبيا‬‎) +218
🇱🇮 Liechtenstein +423
🇱🇹 Lithuania (Lietuva) +370
🇱🇺 Luxembourg +352
🇲🇴 Macau (澳門) +853
🇲🇰 Macedonia (FYROM) (Македонија) +389
🇲🇬 Madagascar (Madagasikara) +261
🇲🇼 Malawi +265
🇲🇾 Malaysia +60
🇲🇻 Maldives +960
🇲🇱 Mali +223
🇲🇹 Malta +356
🇲🇭 Marshall Islands +692
🇲🇶 Martinique +596
🇲🇷 Mauritania (‫موريتانيا‬‎) +222
🇲🇺 Mauritius (Moris) +230
🇲🇽 Mexico (México) +52
🇫🇲 Micronesia +691
🇲🇩 Moldova (Republica Moldova) +373
🇲🇨 Monaco +377
🇲🇳 Mongolia (Монгол) +976
🇲🇪 Montenegro (Crna Gora) +382
🇲🇸 Montserrat +1664
🇲🇦 Morocco (‫المغرب‬‎) +212
🇲🇿 Mozambique (Moçambique) +258
🇲🇲 Myanmar (Burma) (မြန်မာ) +95
🇳🇦 Namibia (Namibië) +264
🇳🇷 Nauru +674
🇳🇵 Nepal (नेपाल) +977
🇳🇱 Netherlands (Nederland) +31
🇳🇨 New Caledonia (Nouvelle-Calédonie) +687
🇳🇿 New Zealand +64
🇳🇮 Nicaragua +505
🇳🇪 Niger (Nijar) +227
🇳🇬 Nigeria +234
🇳🇺 Niue +683
🇳🇫 Norfolk Island +672
🇰🇵 North Korea (조선 민주주의 인민 공화국) +850
🇲🇵 Northern Mariana Islands +1670
🇳🇴 Norway (Norge) +47
🇴🇲 Oman (‫عُمان‬‎) +968
🇵🇰 Pakistan (‫پاکستان‬‎) +92
🇵🇼 Palau +680
🇵🇸 Palestine (‫فلسطين‬‎) +970
🇵🇦 Panama (Panamá) +507
🇵🇬 Papua New Guinea +675
🇵🇾 Paraguay +595
🇵🇪 Peru (Perú) +51
🇵🇭 Philippines +63
🇵🇱 Poland (Polska) +48
🇵🇹 Portugal +351
🇵🇷 Puerto Rico +1
🇶🇦 Qatar (‫قطر‬‎) +974
🇷🇪 Réunion (La Réunion) +262
🇷🇴 Romania (România) +40
🇷🇺 Russia (Россия) +7
🇷🇼 Rwanda +250
🇧🇱 Saint Barthélemy (Saint-Barthélemy) +590
🇸🇭 Saint Helena +290
🇰🇳 Saint Kitts and Nevis +1869
🇱🇨 Saint Lucia +1758
🇲🇫 Saint Martin (Saint-Martin (partie française)) +590
🇵🇲 Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon) +508
🇻🇨 Saint Vincent and the Grenadines +1784
🇼🇸 Samoa +685
🇸🇲 San Marino +378
🇸🇹 São Tomé and Príncipe (São Tomé e Príncipe) +239
🇸🇦 Saudi Arabia (‫المملكة العربية السعودية‬‎) +966
🇸🇳 Senegal (Sénégal) +221
🇷🇸 Serbia (Србија) +381
🇸🇨 Seychelles +248
🇸🇱 Sierra Leone +232
🇸🇬 Singapore +65
🇸🇽 Sint Maarten +1721
🇸🇰 Slovakia (Slovensko) +421
🇸🇮 Slovenia (Slovenija) +386
🇸🇧 Solomon Islands +677
🇸🇴 Somalia (Soomaaliya) +252
🇿🇦 South Africa +27
🇰🇷 South Korea (대한민국) +82
🇸🇸 South Sudan (‫جنوب السودان‬‎) +211
🇪🇸 Spain (España) +34
🇱🇰 Sri Lanka (ශ්‍රී ලංකාව) +94
🇸🇩 Sudan (‫السودان‬‎) +249
🇸🇷 Suriname +597
🇸🇿 Swaziland +268
🇸🇪 Sweden (Sverige) +46
🇨🇭 Switzerland (Schweiz) +41
🇸🇾 Syria (‫سوريا‬‎) +963
🇹🇼 Taiwan (台灣) +886
🇹🇯 Tajikistan +992
🇹🇿 Tanzania +255
🇹🇭 Thailand (ไทย) +66
🇹🇱 Timor-Leste +670
🇹🇬 Togo +228
🇹🇰 Tokelau +690
🇹🇴 Tonga +676
🇹🇹 Trinidad and Tobago +1868
🇹🇳 Tunisia (‫تونس‬‎) +216
🇹🇷 Turkey (Türkiye) +90
🇹🇲 Turkmenistan +993
🇹🇨 Turks and Caicos Islands +1649
🇹🇻 Tuvalu +688
🇻🇮 U.S. Virgin Islands +1340
🇺🇬 Uganda +256
🇺🇦 Ukraine (Україна) +380
🇦🇪 United Arab Emirates (‫الإمارات العربية المتحدة‬‎) +971
🇬🇧 United Kingdom +44
🇺🇸 United States +1
🇺🇾 Uruguay +598
🇺🇿 Uzbekistan (Oʻzbekiston) +998
🇻🇺 Vanuatu +678
🇻🇦 Vatican City (Città del Vaticano) +39
🇻🇪 Venezuela +58
🇻🇳 Vietnam (Việt Nam) +84
🇼🇫 Wallis and Futuna +681
🇾🇪 Yemen (‫اليمن‬‎) +967
🇿🇲 Zambia +260
🇿🇼 Zimbabwe +263

11%

Current Wellness Initiatives

Do you currently have a corporate wellness program in place?*

Yes

If yes, please describe your current wellness initiatives:*

What are the primary reasons for seeking a new or enhanced wellness program?*

Select all that apply.

Improve employee health and well-being

Increase productivity

Reduce healthcare costs

Enhance Company Culture

Other (please specify):

Other Reasons (please specify)*

11%

Employee Demographics and Needs

Age Distribution of Employees (Select all that apply)*

Under 25

25-34

35-44

45-54

55 and above

Primary Job Functions (Select all that apply)*

Executive Management

Administrative

Technical/Engineering

Sales/Marketing

Operations

Other (please specify):

Other Job Functions (please specify)

Work Schedule (Select all that apply)*

Standard 9-5

Shift Work

Remote Work

Hybrid Model

Other (please specify):

Other Work Schedule (please specify)*

What are the most pressing wellness concerns among your employees? (Select all that apply)*

Stress Management

Physical Fitness

Nutrition

Mental Health

Sleep and Recovery

Work-Life Balance

Team Building and Connection

Other (please specify):

Other Wellness Concerns (please specify)*

11%

Program Interests

Which of our labs are you most interested in incorporating? (Select all that apply)*

Movement Lab (Physical fitness and activity)

Mind Lab (Mental health and mindfulness)

Recovery Lab (Sleep, relaxation, and stress reduction)

Nutrition Lab (Diet and healthy eating)

Lifelab Circle [Connection Lab] (Team building and community)

What type of services are you interested in? (Select all that apply)*

On-site workshops and seminars

Virtual webinars and sessions

One-on-one coaching

Group classes

Corporate memberships

Wellness retreats

Team-building activities

Other (please specify)

Other Services (please specify)*

Please rank the following in order of importance for your wellness program (1 = Most Important, 5 = Least Important)

Physical Health*

1 (Most Important)
2
3
4
5 (Least Important)

Mental Well-being*

1 (Most Important)
2
3
4
5 (Least Important)

Nutrition Education*

1 (Most Important)
2
3
4
5 (Least Important)

Stress Management*

1 (Most Important)
2
3
4
5 (Least Important)

Team Building and Connection*

1 (Most Important)
2
3
4
5 (Least Important)

11%

Wellness Retreats and Escapes

Are you interested in incorporating wellness retreats into your program?*

Yes

Maybe in the future

If yes, which of our partner wellness escape properties appeal to you? (Select all that apply)*

Villa Kama (Ubud, Indonesia)

Indigo Beach (Jeddah)

Boho (Jeddah)

Oia Beach (Jeddah)

Indigo Hills (Glamping in Riyadh)

What is the preferred duration for a retreat?

1-2 days

3-5 days

One week

Others (please specify)

Other Duration (please specify)*

What objectives would you like to achieve through a wellness retreat? (Select all that apply)*

Team Building

Stress Reduction

Leadership Development

Creative Thinking

Other (please specify)

Other Objectives (please specify)*

11%

Logistics and Preferences

Preferred Program Format*

In-person

Virtual

Hybrid

Preferred Days for Program Activities (Select all that apply)*

Weekdays during work hours

Weekdays after work hours

Weekends

Flexible

Budget Allocation for Wellness Programs*

Per employee per month/year (please specify amount)

Total annual budget (please specify amount)

Not yet determined

Budget Amount (please specify)*

Are you interested in corporate memberships for your employees?*

Yes

Maybe, need more information

Any specific scheduling considerations we should be aware of?

Mention busy seasons, blackout dates, etc.

11%

Customisation and Additional Needs

How important is program customization to you?*

Extremely Important

Very Important

Somewhat Important

Not Important

Are there any specific health concerns or topics you want to address?

Do you have any existing partnerships or resources that should be integrated with our program?

What outcomes or metrics are you hoping to achieve or improve? (Select all that apply)*

Employee engagement

Productivity

Reduced absenteeism

Employee satisfaction

Other (please specify)

Other Outcomes (please specify)*

How do you plan to measure the success of the wellness program? (Select all that apply)

Surveys and feedback

Health metrics

Participation rates

Performance indicators

Other (please specify)

Other Measurement Methods (please specify)*

11%

Additional Comments

Please share any additional information or specific requests that would help us tailor the program to your needs

11%

Data Privacy

lifelab Integrated Wellness is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please tick below to say how you would like us to contact you:

I agree to receive other communications from lifelab Integrated Wellness.

In order to provide you the content requested, we need to store and process your personal data. If you consent to us storing your personal data for this purpose, please tick the checkbox below.

I agree to allow lifelab Integrated Wellness to store and process my personal data.*

You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

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