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Hello,
Welcome to Section VII of the Personal Factor Inventory: My Medical and Physical Summary.
There are
My Medical and Physical Summary – My Current Health |
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| 701. I have a yearly medical physical. |
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| 702. I suffer from or have been treated for an eating disorder. |
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| 702. I have suffered from the following: |
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| 703. I have been diagnosed or treated for the following psychological disorder/s |
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| 703. I have been diagnosed or treated for the following: |
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| 704. I have heard of the obesity virus “human adenovirus, ad36.” |
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| 705. My pet/pets are overweight even though they are fed normal amounts of food. |
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| 706. I believe that I have a ‘body weight set point’ or a weight that my body prefers to weigh no matter what I eat. |
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| 707. I have been diagnosed with the following illnesses. |
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| 708. I have food allergies or sensitivities to certain foods. |
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| 709. I am allergic to mold in the air. |
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| 710. I take prescription medication. |
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| 711. Select all the medications that you are currently taking: |
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| 713. Body aches and pains restrict my ability to exercise. |
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| 714. Athletic activities and/or exercise are a regular part of my life. |
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| 715. I spend more than 150 minutes exercising on a weekly basis. |
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| 716. I have been consistently exercising: |
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| 718. I exercise in a group (exercise or dance class, team sport). |
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| 719. I participate in the following types of exercise at least 3 times per week. |
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| 720. I usually take ________ steps each day. |
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| 721. I drink at least 6 cups (48 ounces) of fluids on a daily basis. |
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| 722. I consume 250 calories or more each day from my beverage choices. |
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| 723. Four times a week or more, I drink milkshakes, alcohol, frozen ice drinks, or non-alcoholic beer. |
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| 724. I experience symptoms such as stomach pain, gas, bloating, headaches, extreme fatigue, or skin disorders after eating or at the end of the day. |
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| 725. I have unusually dry skin. |
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| 726. I experience an unusual amount of hair loss. |
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| 728. The most that I would be willing to pay to find out if I have been infected with the obesity virus (assuming insurance would not cover the cost) is |
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| Overall, how satisfied are you , with [PRODUCT/SERVICE]? |
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Would you recommend [PRODUCT OR SERVICE] to others?
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| What recommendations would you offer for improving [PRODUCT/SERVICE]? | | |
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