Your name

Your height:
Your weight:
was that imperial or metric
imperial(Inch/Lbs)metric (cm/kg)

How do you rate your level of physical activity?
LowModerateHigh
If your level is between low and moderate, you can check both checkboxes.

Your main job is more related to:
sittingwalkinglifting weightrepetitive movements
Check all that apply

Are you tired at work?
NoRareSometimesOftenConstantly

Do you have any pain after work?
NoRareSometimesOftenConstantly

If YES where do you feel pain?
Probably MusclesProbably JointsI don't know
Check all that apply

How about emotional stress?
NoRareSometimesOftenConstantly

Do you have any physical or sports activity after work?
NoWalkingRunningGymGolfGames like FootballOther
Check all that apply

Exercises
Do you do exercise workouts and stretching?
NoRareSometimesConstantly
Check all that apply

Do you understand that you need to change a lot in your lifestyle?
YesMaybeProbably not

Do you have intentions to change your life?
YesMaybeProbably not

If you have anything to add or clarify, please do it here (optional):

Thank you!

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