Your Health and Wellness Evaluation
Please take a few minutes to complete your Health and Wellness Evaluation. This survey is meant as a guide to be part of a complete assessment process.
These first few questions are required and will help to give you a better evaluation of your personal health.
Do you drink alcoholic beverages?
If yes to above, how often do you drink?
1-2 drinks per week
3-4 drinks per week
5-6 drinks per week
7-8 drinks per week
9-10 drinks per week
More than 10 drinks per week
On average, how many days per week do you get at least 20-30 minutes of moderate exercise?
Do you suffer from any of the following? (Please mark all that apply)
High Blood Pressure
How would you rate your overall health?