Questionnaire

Introduction

Welcome to the Vitality Program Health Questionnaire! This assessment is designed to give us a holistic view of your current health status by focusing on six key areas: Movement, Nutrition, Sleep, Stress Management, Body Composition, and Overall Wellness.

Why This Questionnaire Matters

This questionnaire is an important tool for identifying areas where you can improve your overall health and well-being. However, it is just one part of the full picture. In-clinic assessments, such as mobility/stability testing, body composition analysis, blood marker testing, and metabolic evaluations, are critical in providing a complete understanding of your health. Together, the information gathered from this questionnaire and the tests performed in our clinic will allow us to design a personalized plan to support your vitality and longevity.

Disclaimer

The information in this questionnaire is meant for educational and wellness purposes only and is not a substitute for medical advice or diagnostic testing. We encourage you to consult with your healthcare provider for any concerns that may require medical attention.

Movement Pillar

Movement is key to physical and mental health, but it’s not just about how much you move - it’s also about the variety, quality, and balance between training and recovery. This section evaluates your current movement habits to help ensure that your routine is well-rounded, properly dosed, and aligned with your goals.

Nutrition

Nutrition is a vital part of overall health. A balanced diet with the right amount of protein, fiber, and nutrient-dense foods contributes to physical performance, recovery, and long-term well-being. This section assesses your current nutritional habits to ensure they support your goals.

Sleep 

Sleep is a cornerstone of health and plays a critical role in physical recovery, cognitive function, emotional well-being, and overall vitality. Quality sleep helps regulate metabolism, supports immune function, and is essential for muscle repair and memory consolidation. This section evaluates your sleep habits, including duration and quality, to help ensure you are getting the rest necessary to support your goals and well-being.

Resilience Pillar

Resilience is the ability to adapt and thrive in the face of stress and challenges. Managing stress effectively and maintaining mental health are key components of resilience. Chronic stress and poor mental health can lead to physical and emotional exhaustion, impacting your well-being and performance. This section evaluates your current stress levels, mental health, and the use of techniques like breathing to improve resilience and maintain balance in your life.

Enhancers Pillar

Enhancers are tools and techniques that improve physical performance, recovery, and mental clarity. This section assesses whether you are using supplements or medications to foster overall health, or if you rely heavily on pharmaceuticals.

Community Pillar

Community and social connections play a vital role in maintaining emotional health, accountability, and motivation. People who are engaged with supportive communities often experience greater health outcomes and resilience.

Point Scoring System For Each Pillar

 

1. Movement

Total Maximum Points: 26

• High Score (23-26 points): You are excelling in your movement routine and maintaining great balance between variety, recovery, and performance.
• Moderate Score (18-22 points): You are doing well, but there are areas where you could improve your movement routine, such as variety or recovery.
• Low Score (13-17 points): Your movement routine needs more attention. Consider adding more variety or focusing on recovery.
• Very Low Score (Below 13 points): Significant changes are needed in your movement routine. Increasing frequency or incorporating new types of movement should be a priority.

 

2. Fuel

Total Maximum Points: 44

• High Score (38-44 points): Your nutritional habits are well-balanced and support your overall health and goals.
• Moderate Score (30-37 points): Your diet is generally good, but there are areas where you can improve, such as more balanced meals or tracking your body composition.
• Low Score (22-29 points): You should focus on improving your nutrition and addressing any issues with macronutrient balance, body composition, or blood markers.
• Very Low Score (Below 22 points): Your nutrition needs significant improvement. Focus on balanced eating, improving metabolic markers, and tracking body composition.

 

 3. Sleep

Total Maximum Points: 15

• High Score (13-15 points): Your sleep habits are excellent, and you are getting enough quality sleep for optimal recovery and health.
• Moderate Score (10-12 points): Your sleep is generally good, but you might benefit from more consistent quality or better sleep hygiene.
• Low Score (7-9 points): Your sleep needs improvement. Focus on sleep quality, duration, and feeling more rested upon waking.
• Very Low Score (Below 7 points): Significant attention is needed to improve your sleep patterns. Prioritize getting consistent, restful sleep.

 

4. Resilience (Stress & Mental Health)

Total Maximum Points: 15

• High Score (13-15 points): You are effectively managing stress and maintaining strong mental health, which enhances your resilience.
• Moderate Score (10-12 points): You are managing stress reasonably well, but could benefit from additional techniques or routines to improve mental health.
• Low Score (7-9 points): Your resilience could be improved with more consistent stress-reduction practices and focus on mental health.
• Very Low Score (Below 7 points): You are struggling with stress and mental health. Consider incorporating regular stress-management techniques and seeking support.

 

 

5. Enhancers

Total Maximum Points: 9

• High Score (8-9 points): You are making excellent use of enhancers, including supplements and wearables, to monitor and support your overall health.
• Moderate Score (6-7 points): You are using some enhancers, but there may be additional tools or strategies you could incorporate to optimize your health.
• Low Score (4-5 points): You are not fully utilizing enhancers that could support your health. Consider exploring supplements or wearable devices to track your progress.
• Very Low Score (Below 4 points): Significant work is needed to incorporate tools that support your health, such as supplements or wearables.

 

6. Community

Total Maximum Points: 12

• High Score (10-12 points): You are well-connected to a strong support network and community, which enhances your overall well-being.
• Moderate Score (8-9 points): You have some community connections, but there is room to expand your support system to enhance well-being.
• Low Score (6-7 points): You need to focus on building a more supportive community and engaging in more group activities to foster well-being.
• Very Low Score (Below 6 points): Your community engagement is lacking. Focus on building stronger social connections for emotional and social support.

 

Overall Grading System for Each Pillar:

1. High Score (90-100%): You are excelling in this pillar and maintaining good practices.
2. Moderate Score (70-89%): You are doing well but could make improvements to optimize this pillar.
3. Low Score (50-69%): This pillar needs attention to ensure you’re building a strong foundation for your vitality.
4. Very Low Score (Below 50%): Significant work is needed in this area to support overall health and vitality.