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Test

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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1

How often do you exercise per week?

Choose the option that best reflects your average routine.
2

Which of the following do you consume regularly?

Select all items that apply to your daily or weekly diet.
3

Do you have any chronic medical conditions?

Write down any long-term illnesses or conditions you are diagnosed with.
4

How many hours do you usually sleep per night?

Enter an approximate number of hours you sleep on average.
5

When was your last full medical check-up?

Select the exact date or an approximate if you don’t remember the day.