Do you suffer from excess cholesterol? Yes No

   Do you suffer from high blood pressure? Yes No Lightly

   Do you suffer from cardiac problems Yes No Lightly

   Articulation problems Yes No Sometimes

   Do you have cravings? Yes No Sometimes

   Do you lack of energy? Yes No Sometimes

                                   Personal Wellness Questionnaire 

  1. Do you eat more meals with poultry, len meat, fish and plant (soy) proteins rather than steaks, roats and   other red meats? Yes No

  2. Do you eat a variety of colorful fruits and vegetables and do you eat at least five servings a day of these?     Yes No

  3. Do you consume primarily whole grains (100% whole wheat bread and pasta, brown rice, rather than regular pasta, white rice and white bread? Yes No

  4. Do you eat ocean-caught fish at least 3 times a week? Yes No

  5. Do you avoid the intake of fried foods, dressings, sauces, gravies, butter and margarine? Yes No

  6. Is your digestive system free of indigestion or irregularity? Yes No

 7. Do you get a minimum of 30 minutes of exercise 3-5 days a week? Yes No

  8. Do you maintain a stable and appropriate weight? Yes No

  9. Do you  have time to prepare balanced meals, rather than take out or eating on the run? Yes No

 10. Do you resist the urge to eat typical snack foods (chips, candies, etc.) throughout the day and after dinner?     Yes No

 11. Are you free of water retention and bloating? Answer  no, if you suffer of this problem.Yes No

 12. Do you have the energy and focus you need to meet your daily challenges? Yes No

 13. Do you drink at least 8 glasses of water a day? Yes No

 14. Are you getting your daily recommended allowance of Calcium?    a. men =1,000 mg    b. women under  50 =   1 200 mg  c. Women 50 and over = 1500 mg    ( 4 glasses of milk,  or 4 cups of skim cheese,  or 6 cups of green vegetables) Yes No

 15. Are your blood pressure, triglycerides and cholesterol in the normal range? Yes No

 16a. Men : Are you free from problems associated with your prostate such as slow urination or waking up at night to urinate? Answer NO if you suffer from this problem Yes No

 16b. Women : Are you free from problems associated with your menstrual cycle/menopause such as mood changes, hot flashes or problems sleeping? Answer NO if you suffer from this problem. Yes No