Personal Wellness Evaluation

Question 1 of 16

1

Do you eat more meals with poultry, lean meat, fish and plant (soy) proteins rather than steaks, roasts and other red meats?

Select one of the following:

Yes
No

Explanation

Question 2 of 16

1

Do you eat a variety of colorful fruits and vegetables and do you eat at least seven servings
a day of these?

Select one of the following:

Yes
No

Explanation

Question 3 of 16

1

Do you consume primarily whole grains (100% whole wheat bread and pasta, brown rice) rather than regular pasta, white rice and white bread?

Select one of the following:

Yes
No

Explanation

Question 4 of 16

1

Do you eat ocean-caught fish at least three times a week?

Select one of the following:

Yes
No

Explanation

Question 5 of 16

1

Do you avoid the intake of fried foods, dressings, sauces, gravies, butter and margarine?

Select one of the following:

Yes
No

Explanation

Question 6 of 16

1

Is your digestive system free of indigestion or irregularity?

Select one of the following:

Yes
No

Explanation

Question 7 of 16

1

Do you get a minimum of 30 minutes of exercise three to five days a week?

Select one of the following:

Yes
No

Explanation

Question 8 of 16

1

Do you maintain a stable and appropriate weight?

Select one of the following:

Yes
No

Explanation

Question 9 of 16

1

Do you usually have time to prepare balanced meals, rather than take-out or eating on the run?

Select one of the following:

Yes
No

Explanation

Question 10 of 16

1

Do you stay away from soda and typical snack foods throughout the day and after dinner?

Select one of the following:

Yes
No

Explanation

Question 11 of 16

1

Are you free of water retention and bloating?

Select one of the following:

Yes
No

Explanation

Question 12 of 16

1

Do you have the energy and focus you need to meet your daily challenges?

Select one of the following:

Yes
No

Explanation

Question 13 of 16

1

Do you drink at least eight glasses of water a day?

Select one of the following:

Yes
No

Explanation

Question 14 of 16

1

Are you getting your daily recommended allowance of Calcium?
a. Men = 1,000mg b. Women under 50 = 1,200mg c. Women 50 and older = 1,500mg

Select one of the following:

Yes
No

Explanation

Question 15 of 16

1

Are your blood pressure, triglycerides and cholesterol in the normal range?

Select one of the following:

Yes
No

Explanation

Question 16 of 16

1

Men: Are you free from problems associated with your prostate such as slow urination or waking up at night to urinate?

Women: Are you free from problems associated with your menstrual cycle/menopause such as mood changes, hot flashes or problems sleeping?

Select one of the following:

Yes
No

	Created by Cairyn Orido over 8 years ago

Do you want to make healthy choices for yourself, but aren’t sure where to begin? Take our Personal Wellness Evaluation to get an idea on where to start.

Personal Wellness Evaluation

Question 1 of 16

Do you eat more meals with poultry, lean meat, fish and plant (soy) proteins rather than steaks, roasts and other red meats?

Select one of the following:

Explanation

Question 2 of 16

Do you eat a variety of colorful fruits and vegetables and do you eat at least seven servings a day of these?

Select one of the following:

Explanation

Question 3 of 16

Do you consume primarily whole grains (100% whole wheat bread and pasta, brown rice) rather than regular pasta, white rice and white bread?

Select one of the following:

Explanation

Question 4 of 16

Do you eat ocean-caught fish at least three times a week?

Select one of the following:

Explanation

Question 5 of 16

Do you avoid the intake of fried foods, dressings, sauces, gravies, butter and margarine?

Select one of the following:

Explanation

Question 6 of 16

Is your digestive system free of indigestion or irregularity?

Select one of the following:

Explanation

Question 7 of 16

Do you get a minimum of 30 minutes of exercise three to five days a week?

Select one of the following:

Explanation

Question 8 of 16

Do you maintain a stable and appropriate weight?

Select one of the following:

Explanation

Question 9 of 16

Do you usually have time to prepare balanced meals, rather than take-out or eating on the run?

Select one of the following:

Explanation

Question 10 of 16

Do you stay away from soda and typical snack foods throughout the day and after dinner?

Select one of the following:

Explanation

Question 11 of 16

Are you free of water retention and bloating?

Select one of the following:

Explanation

Question 12 of 16

Do you have the energy and focus you need to meet your daily challenges?

Select one of the following:

Explanation

Question 13 of 16

Do you drink at least eight glasses of water a day?

Select one of the following:

Explanation

Question 14 of 16

Are you getting your daily recommended allowance of Calcium? a. Men = 1,000mg b. Women under 50 = 1,200mg c. Women 50 and older = 1,500mg

Select one of the following:

Explanation

Question 15 of 16

Are your blood pressure, triglycerides and cholesterol in the normal range?

Select one of the following:

Explanation

Question 16 of 16

Men: Are you free from problems associated with your prostate such as slow urination or waking up at night to urinate? Women: Are you free from problems associated with your menstrual cycle/menopause such as mood changes, hot flashes or problems sleeping?

Select one of the following:

Explanation

Do you eat a variety of colorful fruits and vegetables and do you eat at least seven servings
a day of these?

Are you getting your daily recommended allowance of Calcium?
a. Men = 1,000mg b. Women under 50 = 1,200mg c. Women 50 and older = 1,500mg

Men: Are you free from problems associated with your prostate such as slow urination or waking up at night to urinate?

Women: Are you free from problems associated with your menstrual cycle/menopause such as mood changes, hot flashes or problems sleeping?