LiveWell

Answer all questions and then hit the submit button at the bottom of this page.

Physical Fitness

1. I exercise aerobically (continuous, vigorous exercise producing sweat for a minimum of thirty minutes) at least _____ per week.

2. My resting pulse rate is _____ beats per minute.

3. I avoid the extremes of too much or too little exercise.

4. I approach exercise in a relaxed manner.

5. I increase my exercise by walking or biking whenever possible.

6. I stretch before exercising.

7. I stretch after exercising.

8. I get an adequate amount of sleep.

9. My exercise program includes and adequate amount of each of the three major fitness components--endurance, strength and flexibility.

10. If I am not in shape, I avoid sporadic (once a week or less) strenuous exercise.

Physical Nutrition

1. When choosing non-vegetable protein, I select lean cuts of meat, poultry, and fish.

2. I minimize my salt intake.

3. I eat fruits and vegetable fresh and uncooked.

4. I eat breakfast.

5. I include fiber in my diet on a daily basis.

6. I drink enough fluid to keep my urine light yellow.

7. I plan my diet to insure an adequate amount of vitamins and minerals.

8. I minimize foods in my diet that contain large amounts of refined flour (bleached white flour, typical store bread, cakes, etc.)

9. I minimize my intake of fats and oils including margarine and animal fats.

10. I avoid adding sugar to my food and I minimize my intake of pre-sweetened food such as sugar-coated cereals, syrups, chocolate milk, and most processed and fast foods

Physical Self-Care

1. I maintain an up-to-date immunization record.

2. I examine my breasts or testes on a monthly basis.

3. I take action to minimize my exposure to tobacco smoke.

4. When I'm experiencing illness or injury, I take necessary steps to correct the problem.

5. I brush my teeth after eating.

6. I floss my teeth after eating.

7. My resting pulse is 60 or less.

8. I get an adequate amount of sleep.

9. I keep my blood pressure in a range that minimizes my chances of disease (e.g. stroke, heart attack kidney).

10. I keep my cholesterol level, high density lipids and triglycerides in a range that minimizes my chances of disease.

Drugs and Driving

1. I do not operate vehicles under the influence of alcohol or other drugs.

2. I do not ride with vehicle operators who are under the influence of alcohol or other drugs.

3. I stay within the speed limit.

4. I maintain a safe driving distance between cars based on speed.

5. Vehicles which I drive are maintained to assure safety.

6. I avoid use of tobacco.

7. I do not consume more than two alcoholic drinks per day.

8. I avoid using drugs obtained from unlicensed sources.

9. I consider alternatives to drugs.

10. I follow the instructions provided with any drug I take.

Social Environment

1. I take steps to conserve energy in my place of residence.

2. I contribute to the feeling of acceptance within my family.

3. When I see a safety hazard, I take action (warn other or correct the problem).

4. I avoid unnecessary radiation.

5. I contribute time and/or money to community projects.


6. I use creativity in constructive ways.

7. My behavior reflects fairness and justice.

8. When possible, I choose an environment which is free of noise pollution.

9. When possible, I choose an environment which is free of air pollution.

10. I do my part to promote clean air.

Emotional Awareness

1. I am comfortable in my relationships with others.

2. I feel positive about myself.

3. I feel there is an appropriate amount of excitement in my life.

4. My emotional life is stable.

5. When I make mistakes, I learn from them.

6. I feel enthusiastic about my life.

7. I find it easy to laugh.

8. I enjoy my life.

9. I have plenty of energy.

10. My sleep is restful.

Emotional Control

1. I can express my feelings of anger.

2. I say 'NO' without feeling guilty.

3. I make decisions with a minimum of stress and worry.

4. There is an appropriate amount of time urgency in my daily routine.

5. I include relaxation time as part of my daily routine.

6. I am able to develop close, intimate relationships.

7. I set realistic objectives for myself.

8. I can relax my body and mind (without using drugs).

9. I accept responsibility for my actions.

10. I accept the responsibility for creating my own feelings.

Intellectual

1. I keep abreast of social and political issues.

2. I am interested in learning about scientific discoveries.

3. I make an effort to maintain and improve my verbal skills.

4. I make an effort to maintain and improve my writing skills.

5. I am satisfied with the entertainment choices I make.

6. I carefully select my movies and television choices.

7. I maintain a continuing education program relative to my career.

8. I am satisfied with the amount and variety I read.

9. It's easy for me to apply knowledge gained in one situation to a new situation.

10. I am interested in understanding the views of others.

Occupational

1. I enjoy my work.

2. I take advantage of opportunities to learn new skills in my work.

3. My work is challenging.

4. I feel my job responsibilities are consistent with my values.

5. I look forward to doing my job.

6. I am satisfied with the balance between my work time and leisure.

7. I am satisfied with my ability to plan my workload.

8. I receive adequate feedback to judge my work performance.

9. To extent that I can, I create an environment which minimizes my stress.

10. To the extent I can, I create an environment which minimizes the stress at my organizational level or other levels.

Spiritual

1. I am satisfied with my spiritual life.

2. Prayer, meditation, and/or quiet personal time is/are important part(s) of my life.

3. My values guide my daily life.

4. My spiritual growth is an important lifelong process.

5. I am concerned about humanitarian issues.

6. I participate in discussions about spiritual values.

7. Contemplating my purpose in life is an important issue for me.

8. I am satisfied with the degree to which my job is consistent with my values.

9. I am satisfied with the degree to which my leisure time activities support my life goals.

10. I am tolerant of the values and beliefs of others.

The LiveWell system is now fixed. Thank you to those that reported the error.

 
    
 
LiveWell is an educational tool developed by Bill Hettler, MD.  (C) 1977 - 2007