.
Test
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
Start
Secured
Survio
1
How often do you exercise per week?
Choose the option that best reflects your average routine.
Never
1–2 times
3–4 times
5 or more times
Continue
Continue
2
Which of the following do you consume regularly?
Select all items that apply to your daily or weekly diet.
Coffee
Alcohol
Tobacco
Sugary drinks
Continue
3
Do you have any chronic medical conditions?
Write down any long-term illnesses or conditions you are diagnosed with.
Continue
4
How many hours do you usually sleep per night?
Enter an approximate number of hours you sleep on average.
Continue
5
When was your last full medical check-up?
Select the exact date or an approximate if you don’t remember the day.
Continue
Submit