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Surveys
2014
September
L
LIFE EXPECTANCY SURVEY MedLifePro
LIFE EXPECTANCY SURVEY MedLifePro
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Please respond to each question below by checking an answer. The information will be used to calculate your life expectancy and recommend lifestyle changes for life extension.
Your responses will be strictly confidential and your information will be coded. If we have questions at any time about the survey response, MedLife Pro may contact you by email at the email address specified.
Thank you very much for your time and support. Please start with the survey now by clicking on the
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button below.
I Agree
How often do you see a doctor for a regular checkup?
Annually
Every 2 years
Whenever I need to.
Have not seen one past 3 years.
What is your age?
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
38
40
41
42
43
44
45
46
47
48
49
50
51
52
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
How well do you cope with stress?
I handle stress very well by using stress reduction methods such as relaxation, meditation and deep breathing exercises.
I just deal with it on a daily basis and I am doing ok.
Not very well. I Ifeel stressed all the time and it wears me down.
What is your marital status?
Single
Married/living partner
Separated/divorced
Widowed
What is your height in centimeters?
140-145
146-150
151-155
156-160
161-165
166-170
171-175
176-180
181-185
186-190
191-195
196-200
201-205
206-210
211-215
216-220
221+
What is your weight in kilograms?
36.1-40
40.1-45
45.1-50
50.1-60
60.1-65
65.1-70
70.1-75
75.1-80
80.1-90
90.1-95
95.1-100
100.1-105
105.1-110
110.1-115
115.1-120
120.1-125
125.1-130
130.1-135
135.1-140
What is your highest level of education acheived?
primary only
secondary/highschool
tertiary/university
post-graduate/masters
doctoral
How many hours do you spend on your job including travel to and from work?
A normal work week is 8-10 hours a day for 5 days/wk.
A normal work week is 11-13 hours a day or 6 days/wk.
I work more than 14 hours a day or 7 days/wk.
I am retired or working only part time.
What are some of your tipical life stress?
Job related/travel/traffic jam/ running late.
Health problems/ illness or death of a loved one/crime victim/living conditions.
Marital /family stress/financial insecurity/legal problems.
Feeling undervalued/underpaid/loneliness
Some of the above or other significant stress.
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