Annual Health Review

Section

Exercise

1. Physical activity at work

Please tell us the type and amount of physical activity involved in your work, tick the box that is most relevant to you:

2. Physical Exercise

During the last week, how many hours approximately did you spend on each of the following activites? Please state amount in each box:

Diet

How would you say you diet is from Good, Average, or Poor?

Smoking

Do you currently smoke tobacco?
Have you ever smoked?
Do you currently smoke an e-cigeratte/vape?

Alcohol Screening

How often do you have a drink containing alcohol? *
How many units of alcohol do you drink on a typical day when you are drinking? *
How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year? *

Have you received an invitation (letter or text) to book this Annual Health review? *