Health and Survivability Quiz

Physical Status

1. Are you more than 15 pounds overweight?
Yes No

2. Do you need a cane or any other aid to walk?
Yes No

3. Do you have trouble walking for more than 15 minutes without resting?
Yes No

4. Do you experience frequent joint or muscle pain?
Yes No

5. Can you walk up a flight of stairs without stopping?
Yes No

6. Can you run for at least 1 minute without stopping?
Yes No

7. Do you have any diagnosed mobility issues (arthritis, etc.)?
Yes No

8. Can you lift at least 25 pounds without assistance?
Yes No

9. Do you wear glasses or contact lenses for vision correction?
Yes No

10. Do you need hearing aids to hear conversations clearly?
Yes No

11. Do you have trouble with balance or coordination?
Yes No

12. Can you comfortably sit on the floor and stand back up without assistance?
Yes No

13. Are you able to stand for 30 minutes without discomfort?
Yes No

14. Do you have any dietary restrictions or food allergies that limit your intake of key nutrients?
Yes No

15. Do you exercise less than 2-3 times per week?
Yes No

16. Are you able to swim?
Yes No

Medical Status

17. Are you currently taking prescription medications to maintain your health?
Yes No

18. Are you diabetic and require insulin or other medications?
Yes No

19. Do you suffer from high blood pressure and require medication?
Yes No

20. Do you have heart disease?
Yes No

21. Have you had surgery in the last 12 months?
Yes No

22. Do you suffer from asthma and require inhalers or other medication?
Yes No

23. Do you have any chronic respiratory conditions (COPD, etc.)?
Yes No

24. Have you ever been diagnosed with cancer?
Yes No

25. Do you have a diagnosed autoimmune disorder (lupus, MS, etc.)?
Yes No

26. Are you allergic to common environmental factors (dust, pollen, etc.)?
Yes No

27. Do you suffer from severe allergies requiring an EpiPen or emergency treatment?
Yes No

28. Are you prone to frequent infections or illnesses?
Yes No

29. Do you have any digestive or gastrointestinal issues (Crohn’s, IBS, etc.)?
Yes No

30. Do you have a medical condition that limits your physical activity?
Yes No

31. Do you regularly visit a doctor for check-ups or treatments for ongoing conditions?
Yes No

32. Do you have trouble managing pain without medications?
Yes No

33. Do you require a pacemaker or similar device?
Yes No

Mental Status

34. Have you been diagnosed with clinical depression or anxiety?
Yes No

35. Do you take antidepressants, anti-anxiety, or antipsychotic medications?
Yes No

36. Do you take ADD or ADHD medications?
Yes No

37. Do you have a history of mental health disorders in your family?
Yes No

38. Do you have trouble managing stress in high-pressure situations?
Yes No

39. Have you ever experienced a panic attack?
Yes No

40. Do you regularly experience symptoms of insomnia or sleep disturbances?
Yes No

41. Do you have trouble concentrating or focusing on tasks?
Yes No

42. Do you regularly feel overwhelmed or unable to manage daily responsibilities?
Yes No

43. Do you have difficulty making decisions under pressure?
Yes No

44. Do you experience mood swings or emotional instability?
Yes No

45. Have you ever been hospitalized for a mental health condition?
Yes No

46. Do you have a history of substance abuse or addiction?
Yes No

47. Are you single, widowed, or divorced?
Yes No

48. Do you lack a strong support system of family or friends?
Yes No

49. Do you feel socially isolated or lonely?
Yes No

50. Do you often feel hopeless about the future?
Yes No