Cancer Quiz Question Title * 1. Please take a few moments to discover if you are at risk for Cancer. Once your questionnaire is complete, a Health Renewal doctor will evaluate your answers. Please tick the box below if you agree that a Health Renewal doctor can contact you to discuss your results? I agree I do not agree Question Title * 2. What is your Name and Surname? Question Title * 3. Which Skin Renewal branch is your home branch? Brooklyn Bedfordview Claremont Cape Quarter Constantia Fourways Hillcrest Irene Illovo Morningside Parkhurst Somerset West Stellenbosch Umhlanga Willowbridge Question Title * 4. Please select your Gender? Male Female Question Title * 5. What age group best describes you? 18 or younger 19-29 30-39 40-49 50-64 65 or older Question Title * 6. Which of the following cooking oils do you prefer to use? Vegetable Oil Canola Oil Coconut Oil Olive Oil Question Title * 7. How often do you eat processed foods?(For example: bread, cereal, cakes, cookies, chips, etc.) Never Rarely Occasionally Regularly Question Title * 8. How much of a sweet tooth do you have? Rarely do I eat sweets, if ever I do enjoy something sweet from time to time You can't have dinner without dessert! Cake for breakfast? Count me in! Question Title * 9. How often do you smoke?* Never Rarely Socially Regularly Question Title * 10. How often do you drink sodas or sweet drinks?(For example: regular soda, diet soda, sweet tea, fruit punch, etc.) Never Rarely Occasionally Regularly Question Title * 11. How many nights per week do you fall asleep with the TV or light on? Never 1 night 3 nights 5 or more Question Title * 12. How often do you use non-stick cookware? Never Rarely Weekly Regularly Question Title * 13. How would you best describe your body type? Lean Average Overweight Obese Question Title * 14. When it comes to cancer, what is most important to you? Prevention: I want to learn how to prevent cancer Treatment: I want to learn how to treat cancer Prevention & Treatment: I want to learn how to prevent and treat cancer Maintenance: I've beat cancer and want to know how to keep it away Done
