Wellness Test
Choose only ONE answer per question


  1. Do you eat fruits or vegetables at every meal?
     Almost Always
     Occasionally
     Hardly ever

  2. Do you eat 6 to 11 servings of bread, cereal, rice and pasta every day
     Usually
     Sometimes
     Never

  3. How often do you choose nonfat and low-fat food items instead
    of high-fat products at the supermarket?
     Almost always
     Occasionally
     Hardly ever

  4. How many times a week do you eat a healthful breakfast?
     Seven.
     Three to four times.
     Two of fewer.

  5. How often do you eat red meat in a typical week?
     No more than once or twice
     Three or four times
     Once per day

  6. Do you look for ways to get more exercise during your daily routine?
     Often
     Sometimes
     Never

  7. How much time do you spend exercising in a typical week?
     90 minutes or more
     60 to 89 minutes
     1 to 59 minutes
     None at all

  8. Do you perform stretching and flexibility exercises on a regular basis?
     Yes, every week
     Yes, once per month
     No

  9. Do you spend time each week doing weight or resistance training?
     Yes, every week
     Yes, once per month
     No

  10. Characterize your tobacco use.
     I've never smoked or chewed tobacco
     I quit smoking five or more years ago
     I'm trying to quit smoking
     I presently smoke

  11. Characterize your alcohol use
     I don't drink
     I drink moderately (no more than two per day for men,
    one drink per day for women)

  12. Characterize your drug use.
     I don't use illegal drugs
     I use illegal drugs

  13. Characterize your sleep habits.
     I almost always get between 7 and 9 hours of sleep
     I sometimes get between 7 and 9 hours of sleep
     I hardly ever get that much


  14. How would you characterize your present weight?
     I'm within 5 pounds of my ideal weight
     I'm within 10 pounds of my ideal weight
     I'm more than 10 pounds over or under my ideal weight

  15. Do you heed the dosage instructions and warning labels on
    over-the-counter and prescription medications?
     Yes
     No

  16. Do you schedule regular medical screening tests as advised by your doctor?
     Yes
     No

  17. Do you cover-up or use a sunscreen while spending time in the sun?
     Almost always
     Occasionally
     Hardly ever