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Produced in collaboration with Coma Linda UniversityLifestyle Assessment Long Form GETTING STARTED Very poor health. Please circle your current overall LEVEL OF HEALTH.01Excellent health 2345678910b.
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Obtain a copy of the lifestyle assessment long form.
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Fill out your personal information such as name, date of birth, and contact information.
03
Answer questions regarding your lifestyle habits such as diet, exercise routine, smoking and alcohol consumption.
04
Provide information on your medical history and any current health conditions you may have.
05
Be honest and thorough in your responses to ensure an accurate assessment.

Who needs lifestyle assessment long form?

01
Individuals who are looking to gain insight into their current lifestyle habits and make positive changes.
02
Healthcare professionals who are assessing a patient's overall health and wellness.
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The lifestyle assessment long form is a comprehensive document used to evaluate an individual's lifestyle choices and habits.
Individuals who are undertaking a lifestyle assessment program as part of their health or wellness plan may be required to file the long form.
The form can be filled out by providing detailed information about daily routines, diet, exercise habits, stress levels, sleep patterns, and other relevant lifestyle factors.
The purpose of the lifestyle assessment long form is to gather data on an individual's lifestyle choices in order to identify areas for improvement and create a personalized wellness plan.
Information such as daily activities, dietary preferences, exercise routines, stress levels, sleep patterns, and any other relevant lifestyle factors must be reported on the form.
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