Which best describes your general health?
Excellent health with no known health issues, and at proper weight.
Good health except for (manageable) minor aches, pains, and weight issues.
Fair health with issues such as obesity, requiring regular treatment and testing.
Chronically ill requiring profession care, treatment or medications.
Dealing with terminal illness.

Which best describes the basis of your health care objectives?
Maintaining current good health.
Only think about this when illness diagnosed.
Addressing health risks from weight, cholesterol, family history, sleep disorders, etc.
Healing/dealing with existing chronic or terminal illness such as heart disease or cancer.
I have no conscious health care objectives.

Which best describes your involvement in health care decisions:
Passively involved, as trusted physicians make all my decisions.
Actively involved making decisions with my doctors.
Make most of my decisions, without professional consultation.
Limited or defined mostly by insurance coverage.

Rank the following by importance to you:
1=most important 2=moderately important 3=less important 4=least important

Preventive medicine

Weight control

Boosting longevity

Treatment of current condition(s)

Please confirm:
I have not read Designed To Last
I have read Designed To Last

Age

Gender
Female
Male

Ethnicity
Native American
Asian
Black
Hispanic
White
Other

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