Physical Wellness Assessment

Select the statement that applies to you for each item.
I maintain a desirable weight.
Rarely, if Ever
Sometimes
Most of the time
Always
I engage in vigorous exercises for over 30 minutes a day (i.e. Brisk walking, cycling) up to 5 times a week and strengthening exercises 2 or more days a week.
Rarely, if Ever
Sometimes
Most of the time
Always
I get 7‐8 hours of sleep each night and awake feeling refreshed.
Rarely, if Ever
Sometimes
Most of the time
Always
I listen to my body; when there is something wrong, I seek professional advice.
Rarely, if Ever
Sometimes
Most of the time
Always
I abstain from drug abuse both over the counter (OTC) and illicit.
Rarely, if Ever
Sometimes
Most of the time
Always
I responsibly use alcohol. (i.e. Designating sober drivers and avoiding binge drinking).
Rarely, if Ever
Sometimes
Most of the time
Always
I examine my breasts or testes on a monthly basis.
Rarely, if Ever
Sometimes
Most of the time
Always
I protect my skin from sun damage by using sunscreen, wearing hats, and/or avoiding tanning booths and sun lamps.
Rarely, if Ever
Sometimes
Most of the time
Always
I eat at least 5 servings of fresh fruits and vegetables daily and drink water regularly.
Rarely, if Ever
Sometimes
Most of the time
Always
To minimize the risk of spreading sexually transmitted diseases, contracting sexually transmitted diseases and preventing unwanted pregnancy I either abstain from sexual behavior or I use proper protection such as condoms or dental dams.
Rarely, if Ever
Sometimes
Most of the time
Always
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