Lifestyle and Exercise Questionnaire

Are you a "couch potato"? Exercise is an important part of any weight loss or lifestyle improvement regime.

 
LifestyleYesNoDon't Know
1. Do you drink alcohol excessively?
2. Do you smoke?
3. Do you like exercise?
4. Do you exercise daily?
5. Do you exercise infrequently?
6. Do you consider yourself fit?
7. Are you motivated to exercise alone?
8. Do you require someone to motivate you to exercise?
9. Do you have difficulty thinking of ways to exercise?
10. Do you have time to exercise?
11. Do you have a medical condition that prevents you from exercise?
 
Physical AttibutesYesNoDon't Know
12. Do you consider yourself physically strong?