Let's start with your contact info so we can get back to you with your results
Full Name
*
Date of birth
*
Email
*
Your age
*
Your current weight in kilograms?
*
Your height in centimetres?
*
Do you presently smoke tobacco?
*
On a typical week, how much alcohol do you drink?
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None
1–3 drinks/week
4–10 drinks/week
11+ drinks/week
Do you rack up 150 minutes or more of exercise each week?
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At least 150 minutes
60 to 149 minutes
Less than 60 minutes
None
At most meals, is about half your plate fruits & veggies?
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Yes
No
Little interest or pleasure in doing things (last 2 weeks)?
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Not at all
Several days
Half of the days
Nearly every day
Feeling down, depressed, or hopeless?
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Not at all
Several days
Half of the days
Nearly every day
Feeling nervous, anxious or on edge?
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Not at all
Several days
Half of the days
Nearly every day
Not able to stop or control worrying last 2 weeks?
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Not at all
Several days
Half of the days
Nearly every day
Chance you doze off while quietly reading?
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Would never
Slight
Moderate
High
Chance you doze off while watching TV or streaming?
*
Would never
Slight chance
Moderate chance
High chance
Chance you doze off as a passenger in a car for an hour without a break?
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Would never
Slight chance
Moderate chance
High chance
Chance you doze off after lunch or in the afternoon when sitting quietly
*
Would never
Slight chance
Moderate chance
High chance