The Lifegevity Profile

By completing the following questions you will gain a better understanding of the specific areas that will provide you the greatest initial improvement. You will also see results quicker by focusing on the most important areas first. In most cases, exercise nor nutrition will provide the overall health benefits you desire. For it to be most effective, you must incorporate all aspects of the program.

Take a few moments to complete the questions.  Based on your answers, we will send you your results and your top three Lifegevity Essential Guides and the Introductory Guide of your choice for only $29.95.

Confidentiality – We want you to know that the personal information you share will remain just that, personal. Your confidentiality will be respected. All information provided won’t be shared without written consent. Some of the information collected will be consolidated with other information to provide summarization and norm tables for analysis. For more information on our privacy policies please click here.

Name
Email
Phone please enter phone number so we may call if we have questions on your survey, this will not be used for solicitation
Org. Code If completing quiz within a contracted organization, please enter the organization name or code, otherwise leave blank
Choose Please select the Introductory Learning Guide you would like to receive with your program

For each of the following questions, answer from 0 (never) to 10 (always). You may also answer by what percentage of the time the question pertains to you. For example, 1=10%, 5=50%, 8=80%, etc.

1. I have a tough time making changes
2. I'm always replaying scenarios in my mind on how I wish I had handled a situation
3. I worry more than others
4. I feel I do not get enough exercise
5. Eating out a lot makes it difficult for me to eat the right kinds of foods
6. I always feel I get distracted by minor issues
7. I like things to remain the same
8. I wish I had more confidence
9. I don’t sleep well because I have trouble turning off my mind
10. I need to improve my flexibility
11. I eat a lot of processed foods with salt, sugar and fat
12. I don’t have a sense of fulfillment in what I do
13. New situations make me feel uncomfortable
14. I feel others handle conflict better than I do
15. I have trouble focusing on one project at a time
16. The exercises I do are not giving me the results I want
17. I tend to eat when I get depressed or irritated
18. I feel unfocused and have little control over my life
19. I always wait until the last minute to finish things
20. I prefer to work alone rather than within a group
21. My muscles always feel tense in my neck and shoulders
22. I periodically have lower back pain
23. With all of the marketing it’s hard to understand what foods are good for you
24. I never have time to get the things done that I feel are most important
25. I always second guess decisions after they are made
26. I have few close relationships with family and friends
27. I have trouble relaxing
28. I have poor posture
29. I have a poor understanding of the amount of nutrients I need and what I consume daily
30. Other people are more successful than I am

Once you have completed answering the questions please press to complete your profile.

At anytime you may press to clear your answers and start over.

 

 

 

Privacy Statement   
©2005 Lifegevity Institute