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Intake

To properly serve you and enable you to resolve your needs for the wellness campaign, we need to ask you for some helpful information.

Let's learn a little bit more about you

Basic information

Wellness routine

How often do you exercise
How often you get a full night's rest?
How often you use recreational drugs?
How would you describe your eating pattern?
How often do you drink alcohol?
How often do you use tobacco?

Personal wellness challenges

How anixous would you descibe yourself
Question?

Interpersonal wellness challenges

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Question?

Power wellness challenges

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Question?

Structural wellness challenges

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Question?

Aspirations in life

Check each health challenge you currently face: Required
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