GAUYAFIT HOLISTIC FITNESS ASSESSMENT GAUYAFIT HOLISTIC FITNESS ASSESSMENT Let's get started with designing your individualized, holistic fitness program for optimal aging. OK Question Title * 1. Let me get to know you Name Address City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number OK Question Title * 2. I have exciting dreams and goals to look forward to Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 3. I am self-aware and enjoy living in the moment (I don't dwell on the past or the future). Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 4. I feel a strong sense of purpose in my life Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 5. I am in control of most things in my life Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 6. Humor, laughter and playfulness are part of my daily life Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 7. I live my life with passion and joy Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 8. I am an optimistic person. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 9. I feel like my life is in balance physically, mentally, emotionally and spiritually. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 10. When my life feels, "out of control" or overly stressful, I choose healthy behaviors to help me re-center, relax and renew Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 11. I find positive ways to deal with stress (e.g., exercise, meditation, yoga, spending time in nature or other stress-reducing practices). Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 12. Negative stress and over-whelm are problems for me. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 13. I am the Captain of my ship. I know that I am responsible for my own happiness and well-being. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 14. I am physically able to do everything I want to do in my life. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 15. I exercise at least five days a week on a regular basis Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 16. I eat a healthy, balanced diet made up of mostly unprocessed healthy foods (e.g., vegetables, fruits, high-fiber whole grains and carbohydrates, healthy fats and high-quality protein). Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 17. I drink at least 8 x 8 oz. glasses of plain water most days. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 18. I have plenty of energy to get myself through the day and do the activities that I want to do with ease. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 19. My digestion and gut health rarely give me trouble. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 20. I sleep 6-8 hours most nights. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 21. I have health challenges that impact my lifestyle significantly (e.g., high BP, diabetes, anxiety/depression, sleep apnea, high cholesterol or triglycerides, orthopedic issues, chronic headaches or pain). Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 22. I have plenty of support and accountability to help me reach my health-, fitness- and wellness goals. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 23. I have faith in a Higher Power that sustains me. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 24. My significant other/spouse/partner always has my best interests in mind and wants to see me evolve, grow and learn new skill, habits and become my BEST self. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK Question Title * 25. My close friends and family always have my best interests in mind and want to see me evolve, grow and learn new skills and habits. Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way Never feel this way Rarely feel this way Sometimes feel this way Often feel this way Always feel this way OK DONE
