11. My most eaten three meals are & why? (E.g. cobb salad, peperoni pizza, chicken & broccoli, beans & rice, etc.) a Chichen + Kice _Fevgute food, clersothy Weals bey b. Tovuex SE Césy fo Maal c. Steel’ of Grek Filling Ga sade GF pr tier 12. My least eaten three meals that | believe | should eat, are & why? a sated good nu ieiend b. eed + ents end F chy Wee is c. 3 Goncl (een met vo) fy & pation 13, My food choices have litte to do with my overall health a. Strongly agree b. Agree c._Neither agree or disagree fe. Strongly disagree 14, I typically eat unprocessed (natural form) foods. a. Strongly agree +a c. Neither agree or disagree d. Disagree fe. Strongly disagree 15. Rank the top 5 factors which have the greatest impact on my overall wellness. (1-greatest impact) Z Food quality/intake ___Water quality “1_ The health of the environment in which | live ___ Hygiene Genetics __Air quality _/_ Activity levels S_Myrelationships ___ Degree of intellectual stimulation Occupation _3 Sleep quality ___ Spiritual satisfaction ___Income/wealth ___Other 16. Each week | exercise a. Everyday Sb S-6 tas cc. 3-4days d. 1-2days e. Rarely/never 17. When | exercise, | typically do so at 4. Ahigh intensity —b— Moderate intensity Low intensity d. Casually e. None of the above 48. | rate my current health as: a. Significantly above the average American of similar age b. Above the average American of similar age cc “Similar to the average American of similar age” d. Below the average American of similar age Significantly below the average American of similar age 19. Why? Lam én (sdnne Me pee elm anda peters, Fhept? auf vim Cbg ch fe 20. My primary reason for selecting this course is (it can be it best ft my schedule...?) Zt At val py eng PChedle 60 ¢ eieelined tardy need rity” ncbi ts