Health Optimisation Evaluation

Health Optimisation Evaluation

Reflection on Life and Change
  • Your Details

  • General Questions

  • Lifestyle

  • Please indicate your level of current exercise. A session would be at least 30mins per time. Please use the comments field to expand if needed.
  • When you do exercise generally what level of intensity do you work at.
  • Sleep

  • 1 Very Bad - 5 Excellent
  • Do you have any idea why you sleep is rated the way it is? What could you think of that could improve your sleep?
  • Do you go to bed at a similar time each night?
  • Stress

  • 1 low 5 high
  • Is your stress related to work, family, you? Is it worse on the weekend or during the week. What do you to to reduce stress
  • Happiness

  • 1 low 5 high
  • What do you do that makes you happy, What can you do to improve this?
  • Body Composition

  • What do you think about your body. Are you muscular, lean, overweight, underweight, flabby, tight, what would you like to change if you could?
  • What is your Height in cm
  • What is your weight in kgs
  • Nutrition

  • Addictions

  • Health Function

  • As a child or teenager can you recall if you were prescribed antibiotics often. Indicate if you re-call was it once in a while, often, constantly or rarely. Also if you know what for?
  • Please list any medications you are currently taking.