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ADVANCED PHYSICAL WELLNESS QUIZ

How often do you participate in low impact & flexibility exercise per week? (Swimming, Pilates, Bike riding, Yoga)
1 - 3 x per week
3 - 5 x per week
5+
Never
How often do you participate in strength training exercise per week? (Weights)
1 -3 x per week
3 -5 x per week
5+
Never
How often do you participate in heart pumping cardio exercise per week? (Running, Aerobic classes, swimming)
1 - 3 x per week
3 - 5 x per week
5+
Never
Do you have trouble falling asleep at night?
Yes most nights
Rarely
No I fall asleep very easily
Do you sleep uninterrupted for 7-8 hours per night?
Yes most nights
Rarely
No never
Do you wake up feeling refreshed & energised?
Yes
Rarely
Never, I'm always still tired when I wake up
How much water do you consume each day?
None
1-3 glasses
2 litres +
How many processed drinks do you consume each day? (Soft drink, store bought juice, cordials, sport drinks etc)
None
1-3 glasses
1.2 litres +
How many caffeinated drinks do you consume each day?
None
1-3 cups
3+
How many pieces of fruit do you have per day? (Does not include tinned, packaged or dried fruit)
None
1-2
3+
How many serves of vegetables do you have each day? (Does not include tinned food)
None
1-3
3-5
5+
How many serves of red meat do you have per week? (Does not include deli meat, processed meat slices, salami or sausages)
None
1-3
3-5
5+
How many serves of white meat (chicken, pork, turkey) do you have per week? (Does include deli meat, processed meat slices, salami or sausages)
None
1-3
3-5
5+
How many serves of Fish / Seafood do you have each week? (Does not include crumbed or packet fish fingers etc)
None
1-3
3-5
5+
How many take away / fast food meals do you consume per week?
None
1-5
5+
How many sweet / salty snacks do you consume per week? (potato chips, muffins, chocolate, ice cream, biscuits, crackers,cakes, pastries etc)
None
1-5
5-10
10+
Do you consume low / reduced or skim fat foods?
Yes
No
How many serves of cow dairy products do you consume each week? (Milk, Hard Butter, Cheese, Yoghurt)
None
1-5
5-10
10+
How many serves of wheat products, including gluten free, do you consume per week? (Bread, pasta, wraps, rolls, pies, sausage rolls etc)
None
1-5
5-10
10+
What do you usually use:
Butter that hardens in the fridge
Spreadable margarine
Neither
What oil do you use?
Canola
Vegetable
Olive
Coconut
Other
Do you suffer with headaches?
Never
Once a month
A few times a year
Very frequently
Check the box next to any of the following digestive disturbances that you experience regularly:
Indigestion
Heartburn
Bloating
Nausea
Flatulence
Diarrhoea
Constipation
Irritable bowel
Bad breathe
Burping
Digestive pain & cramping
None of the above
Check the box next to any of the following that you regularly experience:
Back pain
Slow wound healing
Bruises
PMS
Fatigue
Joint pain
Arthritis
Cold & flu
Sneezing
Coughing
Hayfever
None of the above
Do you smoke regularly?
Yes
I have never smoked
I have quit
Social smoker
Do you consume more than 9 standard alcoholic drinks per week?
Less than 9 standard drinks per week
I do not drink alcohol
More than 9 standard drinks per week
Do you drink more than 3 (women) or 4 (men) standard alcoholic drinks in one sitting?
Yes
No
Do you seem to have more mental energy in the evening than any other time of the day?
Yes, I'm wired at night
No, I'm worn out at night
I feel normal & relaxed at night
How would you rate your average energy levels throughout your day
Extremely fatigued
Tired, yawning
Inconsistent
Consistent energy
Highly energetic
What is the condition of your hair?
Dry
Normal
Falling out
Oily
Other
What is the condition of your skin?
Acne
Oily
Sensitive
Dry
Flaky
Pimple breakouts around menstruation
Combination
Ezcema
Psoriasis
Normal
Other
Do you have food cravings often? (sweets, coffee, salty or savoury foods)
Yes every day
Never
Sometimes
Do you carry extra weight around your midsection / stomach area?
Yes
No
Do you regularly consume medication (over the counter pain meds or prescription)?
Yes often
Rarely
Never
Do you regularly take antibiotics?
Yes quite often
Rarely
Never
Do you suffer with mood swings?
Yes daily
Never
Sometimes
Do you have gum / teeth conditions?
Yes currently
Never
I have in the past
Do you have blood pressure concerns?
Yes currently
Never
I have in the past
Do you have any diagnosed chronic health conditions?
Yes currently
Never
I have in the past but have it under control now
Do you usually recognise & address health symptoms as soon as they appear?
Yes, I take medication as soon as I feel a symptom
Yes, I use natural remedies, nutritional medicine & lifestyle changes to assist in healing as soon as I feel symptoms arising
I usually ignore them, push through & hope they go away
I don't usually notice anything until I'm really sick
I very rarely ever get sick
Do you have any known food intolerance's?
Yes
Never had a symptom
I don't know
Do you have any known allergies?
Yes
Never had a symtpom
Do you have any family history (parents / grandparents) with any chronic health conditions?
Yes
No
I don't know
Did you have any serious health conditions as a child?
No
Yes
I don't know
Do you practice mindful breathing each day?
Yes
No
Sometimes
Check the box next to any of the conditions below that affect you regularly:
Anxiety
Deep sadness
Feeling unworthy
Feeling unloved
Depression
Extreme fatigue
Fear
Worry
Feeling out of control
Deep anger
Jealousy
Paranoia
Overwhelm
Other
None of the above
Do you practice daily meditation?
Yes
No
Sometimes
How many hours per day are you sitting down or standing still? (At desk, counter, table, on the lounge, in car/bus/train/plane etc)
Up to 1 hour per day
1-4 hrs per day
4-8 hrs per day
8+ hrs per day
How much time do you spend in natural sunlight per day? (Does not include filtered sunlight through glass - building or car window)
Up to 1/2 hr
1/2 hr - 3 hrs
3+ hrs
Not at all
How many hours per week do you spend outdoors enjoying nature without technology? (Bush, lake, ocean etc without being on the phone, laptop, ipod, ipad or any other technology device)
Never
Up to 1 hr per week
1-3 hrs per week
3 - 6 hrs per week
6+ per week
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