New Year - New You Healthy Living Survey

Take this Healthy Lifestyle Survey Today!

It will be a great way to monitor your progress as you stay active, healthy and fit in 2012!  Re-Take this as soon as every 6 weeks or wait 6 months to see dramatic results

Lifestyle Habits

1) Do you smoke? ____

2) Do you drink more than one alcoholic beverage per day? _____

3) Do you hydrate well (6 to 8 twelve ounce glasses)? _____

4) How many caffeinated beverages do you consume per day? _____

5) How many sodas / sugary drinks do you consume per day? _____

Nutritional Habits

1) How many meals do you eat per day? _____

2) How many between meal snacks per day? _____

3) Do you know how many calories you consume on an average day? _____

Active Lifestyle Habits

1) Are You Regularly Active (30 min per day most days of the week)? _____

2) Is your job physically demanding? ____

3) Do you participate in a regular exercise program? _____

4) How many days per week are you doing Cardiovascular exercise (20 min+)? _____

5) How many days per week are you doing Strength Training? _____

6) How many days per week are you stretching? _____

7) How many days per week do you practice balance training? _____

8) How many days per week do you practice good posture exercises? _____

9) How many days per week are you active with your family, kids, etc? _____

General Fitness

1) On a 10 scale (1=Complete Exhaustion, 10= Not even Breathing Hard) How do you feel after climbing 1 flight of stairs? _____

2) On a 10 scale, how do you feel after climbing 5 flights? _____

3) Weight ____

4) BMI (calculate here: http://www.nhlbisupport.com/bmi/ )_____

5) Waist Circumference (take this 2 finger tips above your navel) ____

6) Hip Circumference (take this at the widest part of your booty) ____

Stress

1) On a 10 scale (1=mentally overwhelmed & exhausted, 10 = stress free), how much stress do you feel in everyday life? _____

2) On the same 10 scale, how much stress do you feel in your professional / work life? _____

3) How many days per week do you do something good (specifically) for your mental health? ___