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    Name (required)

    Your Email (required)

    Address

    City

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    Occupation

    Age

    Height

    Weight

    How long have you been at your current weight?

    Which H&H team member or client referred you?

    When you are faced with an unfamiliar problem, what do you usually do?
    Address the problem immediatelyThink about what to do and then take actionSit back and let things work out for themselves

    Compared with other co-workers, how quickly do you usually complete your tasks?
    I am usually finished before everyone elseI finish faster than most of my co-workersI finish right on timeI frequently turn in tasks late

    During normal conversation,how quickly do you speak?
    Faster than most peopleAt an average paceSlower than most people

    How often do you finish other people's sentences because they speak too slowly?
    FrequentlySometimesAlmost never

    Have you ever been waiting at the doctor's office 30 minutes past your appointment time, and have several chores to do when you get home. What do you do?
    Read a magazineKeep checking your watchGet impatient and somewhat angryComplain to the nurse

    How often are you late for appointments?
    Most of the timeSometimesRarelyNever

    When you are playing a game, how important is it for you to win?
    Very importantSometimes importantNot important at all

    How would your co-workers and friends rate you?
    Always hardworking and seriousSometimes hardworking and seriousRarely hardworking and seriousCarefree

    How would your closest friends rate your general activity level?
    Too slow - never gets anything doneSlow - but gets things doneAverage - reasonable busyToo active - should slow down

    When you have free time, what would you prefer to do?
    SleepWatch TVGo ShoppingCatch up on work or household chores

    Looking back now, how would you rate your behavior as a child?
    I was a problem childI was difficult to disciplineI was an ordinary childI was a little angel

    Do you keep a daily schedule or calendar of your plans?
    No, neverSometimesYes, always

    When you are in a group situation (like completing a group project), how do you usually act?
    I rarely participateI act as a team playerI take charge

    How far in advance would you prepare for a group presentation?
    Two weeks ahead or moreAbout one week before the testA day or two beforehandI usually don't prepare

    What is an ordinary day in your life like?
    Full of problemsFull of funA mixture of problems and funThere are never enough things to keep me busy

    How many days per week do you engage in physical exercise?
    Four or moreTwo or threeOneI don't exercise