Health and Wellness Survey
This survey aims to gather information about your current health status, habits, and overall well-being. Your responses will help us understand common health concerns and promote healthier living in our community.
How would you rate your overall physical health?*
Please think about your general physical well-being in the past month.
Do you have any chronic medical conditions?*
Please select any long-term health issues that you have been diagnosed with by a healthcare professional.
On average, how many days per week do you engage in physical activity (at least 30 minutes per session)?*
Tell us how often you exercise, including walking, sports, or gym workouts.
How many servings of fruits and vegetables do you usually eat per day?*
Consider both fruits and vegetables combined.
How satisfied are you with your current mental/emotional health?*
Rate your level of satisfaction with your overall mental and emotional well-being.
Which of the following preventive health measures do you regularly practice?
Select all that apply to your lifestyle.
What is one health goal you would like to achieve in the next six months?
Share your personal health improvement objective.
How often do you experience sleep difficulties (e.g., trouble falling or staying asleep)?
Reflect on your sleep over the past month.
Is there anything else you would like to share about your health or wellness?
Feel free to include any concerns, suggestions, or comments you may have.
Thank you for taking a part in this survey.
