Do you have any children? YesNo
Do you feel the need to gain or lose weight? YesNo
Do you suffer from chronic illnesses? YesNo
Do you smoke tobacco products? If yes, how often? DailyA couple of days per weekOnly when under stressOnly sociallyNo
Do you drink alcohol? If yes, how often? DailyA couple of days per weekOnly when under stressOnly sociallyNo
How would you gauge your overall health situation? Not very healthySomewhat HealthMostly HealthyIn perfect Health
Are you ready to change your life for the better? YesNo
How stressful do you find your occupation? Not stressful at allBarely stressfulSomewhat stressfulVery stressfulExtremely stressful
How stressful do you find your personal life? Not stressful at allBarely stressfulSomewhat stressfulVery stressfulExtremely stressful
Does your occupation involve physical activity (e.g.: picking heavy things up and putting them down, a lot of walking, etc.). If yes, how much? None at allA little activityLow activityMedium activityHigh activity
Do your hobbies involve physical activity (e.g.: jogging, climbing, biking, running, sports, gym visits, etc.). If yes, how much? None at allA little activityLow activityMedium activityHigh activity
How often do you find yourself feeling like you have gotten enough calories out of your meals? NeverVery rarelyOnce per week at mostA couple of days per weekEvery Day
How often do you have organic foods? NeverVery rarelyOnce per week at mostA couple of days per weekEvery Day
How often do you eat home-cooked meals? NeverVery rarelyOnce per week at mostA couple of days per weekEvery Day
How often do you have fruits and vegetables? NeverVery rarelyOnce per week at mostA couple of days per weekEvery Day
Do you eat junk food and similar products (which could be classified as such)? If yes, how often? NeverVery rarelyOnce per week at mostA couple of days per weekEvery Day
Do you drink soft drinks and similar products? If yes, how often? NeverVery rarelyOnce per week at mostA couple of days per weekEvery Day
Do you feel like you drink enough water? YesNo
How many liters of water do you drink per day? Less than 1LAbout 1LAbout 1.5LAbout 2LMore than 2L
Do you find it easy to drink enough water? Very easySomewhat easyRather difficultVery difficultAlmost impossible
Do you drink water from plastic containers, or do you purchase only glass bottles? Plastic containersGlass bottles
