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Questionnaire template

Health and Fitness Habits

Profiles a programme member's diet, exercise trends and sleep so that wellness advice can be personalised.

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Questions in this template

Eating Habits

  1. Thank you for taking part. These few questions about your eating, exercise and sleep help us shape advice that suits you.

  2. Which of these best describes the way you usually eat?

    Choose one from a list:

    • Vegan
    • Vegetarian
    • Pescatarian
    • Omnivore
    • Other
  3. Please describe your diet.

    Condition: Shown when Other is selected

    Open answer

  4. How often do you eat processed or packaged convenience food?

    Choose one:

    • Never
    • Rarely
    • Sometimes
    • Often
    • Always

Exercise

  1. Compared with six months ago, how often do you now do each of these activities?

    • Running
    • Yoga
    • Weight training
    • Cycling

    For each row: choose one:

    • More often
    • About the same
    • Less often
    • I don't do this activity
  2. What is the main reason you exercise?

    Choose one:

    • General health
    • Managing my weight
    • Relieving stress
    • Keeping my body working well
    • Other
  3. What is your main reason for exercising?

    Condition: Shown when Other is selected

    Open answer

Sleep

  1. On a typical night, how many hours do you sleep?

    Choose one:

    • Less than 5 hours
    • 5–6 hours
    • 7–8 hours
    • 9 hours or more
  2. What, if anything, most often stops you from sleeping well?

    Choose one:

    • Stress from work
    • Difficulty falling or staying asleep
    • Noise or interruptions at home
    • Nothing in particular
    • Other
  3. What else gets in the way of your sleep?

    Condition: Shown when Other is selected

    Open answer