Health/Stress Assessment As the saying goes . . . It isn't what you do occassionally that hurts or helps you, it is what you do everyday. Factors, in your everyday life, alone or in combination contribute to the Health/Stress Risk. People are simply unaware of the impact of the environment at work or home, lifestyle choices they make and the food they consume. The first step is to identify the factors that might be affecting you. Once you have completed the questionaire, honestly assess the things you can realistically change - change your answers to compare the impact of the change. For the factors outside of your control, consider the impact and the most likely way you can compensate for the damage. Develop a plan and start changing the things under your control. For the factors that are outside of your control, develop a plan and implement to compensate for the missing or uncontrolable elements. For your diet, it is often a supplement. One final thought - The definition of insanity is: Doing the same things over and over again and expecting the outcome to be different. When you want to change the ways things are, you must change the things you do. To access your Health/Stress levels, complete the following questionaire:

1) How many cigarettes do you smoke per day?

1. I don’t smoke
2. 10 a day
3. 1 pack a day
4. 1 to 2 packs a day
5. More than two packs a day

1. I don’t drink
2. I drink a little (one or two glasses of red wine a week)
3. I drink moderately (one to two glasses a day)
4. I drink a lot (two to three glasses a day)
5. I drink excessively (more than three glasses a day)

1. Never
2. Sometimes
3. Moderately
4. Frequently
5. Very frequently

1. Never
2. Rarely
3. Often
4. Frequently

1. Never
2. Rarely
3. Weekly
4. Daily

1. Daily
2. A few times a week
3. A few times a month
4. Never

7) Type of oven you own

1. Electric oven
2. Wood-burning oven
3. Gas oven

1. No
2. Yes

1. Yes
2. No

1. Bottled mineral water
2. Tap water

1. With water
2. Generally with water
3. Varies
4. Often deep-fry
5. Frequently deep-fry

1. Very often
2. Often
3. Rarely
4. Never

1. Very often
2. Often
3. Rarely
4. Never

1. Every day
2. Sometimes
3. Rarely
4. Never

1. Every day
2. Sometimes
3. Rarely
4. Never

16) Where do you live?

1. In the country side (isolated area)
2. In a village (500-1,000 inhabitants)
3. In a town (1,000-20,000 inhabitants)
4. In a small city (20,000-200,000 inhabitants)
5. In a big city (more than 200,000 inhabitants)

1. Quiet
2. Slightly noisy
3. Moderately noisy
4. Noisy
5. Very noisy

1. Old (more than 5 years old)
2. Recent (1 to 5 years old)
3. New or remodeled (less than 1 year old)

19) Do you use detergents (at least once a week)?

1. No
2. Yes

1. No
2. Yes

1. No
2. Yes

1. No
2. Yes

23) Exposure to harmful chemical substances (toxic products, paint…)

1. Very slight
2. Slight
3. Average
4. High
5. Very high

1. Slight
2. Average
3. High
4. Very high

25) Your age

1. Less than 40 years old
2. 40-50
3. 50-60
4. 60-70
5. 70-80
6. 80-90
7. Over 90

26) Allergic tendencies?

1. No
2. Yes

1. Never
2. Sometimes (once to twice a year)
3. Often (three to six times a year)
4. Very often (more than six times a year)