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How Long Will You Live?

This Test Will Complete A Description Of Your Life Expectancy For You.
Complete The Questions Below



1)

Location: Where Do You Live?

 
 
 
 
 

2)

Age: How Old Are You?

 
 
 
 
 

3)

Gender: Male Or Female?

 
 
 
 

4)

Family History: How Many Parents/Grandparents/
Great-Grandparents Lived Past 80?

 
 
 
 
 
 

5)

Family History: What Is Your Mother's Status?

 
 
 
 
 
 

6)

Family History: What Is Your Father's Current Status?

 
 
 
 
 
 

7)

Family History: How Many People Died Of A Medical Condition Of Cancer Or Diabetes?

 
 
 
 
 
 
 
 
 

8)

Smoking: Do You Smoke?

 
 
 
 
 
 

9)

Alchaol Consumption: How Much Alcahol (Excluding Red Wine) Do You Drink Every Day?

 
 
 
 
 
 
 
 

10)

BMI: What's Your BMI?

 
 
 
 
 
 

11)

Health: Avearge Blood Pressure?

 
 
 
 

12)

Health: What's Your Cholestrol?

 
 
 
 
 

13)

Diet: How Much Of Your 5 A Day Of Fruit Do You Eat?

 
 
 
 
 
 
 

14)

Diet: How Much Fat Does The Food You Eat Have?

 
 
 
 

15)

Every Day, How Much Do You Exersice?

 
 
 
 
 
 

16)

Mood: How Happy Are You?

 
 
 
 
 

17)

Mood: How Stressed Are You?

 
 
 
 

18)

Education: What Is Your Education Level?

 
 
 
 
 

19)

Driving: How Many Driving Accidents Have You Haade In The Past 5 Years?

 
 
 
 

20)

Driving: How Many DUIs Did You Have In The Past Five Years?

 
 
 
 

21)

Fiinally, How Often Do You Wear A Seatbelt?

 
 
 
 


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