Health Risk Assessment (HRA) Survey

What is your zip code?(Required.)

Please provide us with a four digit code. Such as the last 4 digits of your S.S.#, last 4 of your phone number, any other 4 digit # that you will remember. (Required.)

Current physical activity level.

Select the statement that best describes your current level of physical activity.
Vigorous exercise includes: jogging, running, fast cycling, aerobic classes, swimming laps, singles tennis and racquetball.
Moderate exercise includes: brisk walking, gardening, slow cycling, dancing, doubles tennis or hard work around the house.
(Required.)

I don't exercise or walk regularly now, and I don't plan to start in the near future.

I don't exercise or walk regularly, but I've been thinking about starting.

I'm doing moderate or vigorous physical activities for at least 30 minutes on some days, but fewer than 5 days a week.

I've been doing moderate or vigorous physical activities for at least 30 minutes in a day, on five or more days a week, and have been doing it for the last 1 to 6 months.

I've been doing moderate or vigorous physical activities for at least 30 minutes in a day, on five or more days a week, and have been doing it for 7 months or longer.

Health Risk Assessment (HRA)

Healthy Living Partnership