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The SeniorLife Challenge: A Health Program for Seniors
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1.
Name:
(Required.)
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2.
Month:
(Required.)
January
February
March
April
May
June
July
August
September
October
November
December
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3.
On average, how many steps do you take each day?
(Required.)
Number of Steps
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4.
On average, how many servings of fruit do you get each day?
(Required.)
Number of Servings
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5.
On average, how many servings of vegetables do you get each day?
(Required.)
Number of Servings
