What do you want to change? Pick 3*
On average do you eat....*
On average do you drink....*
On average how many times a week do you eat out?*
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
Do you feel pain in your chest when you perform physical activity?*
In the past month, have you had chest pain when you were not performing any physical activity?*
Do you lose your balance because of dizziness, or do you ever lose consciousness?*
Is your doctor currently prescribing an medication for your blood pressure or for a heart condition? Is your doctor currently prescribing an medication for your blood pressure or for a heart condition?*
Are you currently pregnant?*
Do you have diabetes or thyroid condition?*
Do you know of any reason why you should not engage in physical activity?*
Do you plan to become pregnant in the next three months?*
Do you have a bone or joint problem that could be made worse by a change in your physical activity?*
If you answered yes to any of these questions, have you been medically cleared by your doctor?*
