Have You Ever Smoked?

  Yes, very often
  Never
  Sometimes

What is Your BMI Index?

  Below 18.5
  18.5 to 24.9
  25.0 to 29.9
  30.0 to 39.9
  40.0 or above

Do You Have Good Dental Hygiene?

  I don't brush or floss regularly
  I brush, but don't floss regularly
  I brush and floss once daily
  I brush and floss twice daily
  I brush and floss three times daily

Do You Read Books Often?

  Yes
  No

Do You Play Extreme Sports?

  Yes, often
  Never
  Sometimes

How Much T.V./Computer do You Watch in A Day?

  I don't watch T.V.
  1-2 hours
  3 hours
  4-5 hours
  6 hours or more

How Often do You Drink Alchohol (Excluding Wines)?

  Not every day
  1 to 3 drinks per day
  3 to 5 drinks per day
  6 drinks or more per day

How Much Rest do You Get Each Night/Day?

  5 hours of rest or less
  6 to 9 hours of rest
  10 hours of rest or more

How Much Exercise do You Get?

  None or not much exercise
  Moderate exercise
  Intense exercise