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Get Health Enhancement Lifestyle Profile Guide For Clinicians

Name Date HEALTH ENHANCEMENT LIFESTYLE PROFILE Screening Form HELP SCREENER Please check Yes or No for each of the following statements. Yes No 1. I spend sufficient time taking good care of myself e*g* grooming showering cooking house cleaning. 2. I avoid health-risk behaviors e*g* excessive drinking smoking consuming over-the-counter drugs. 3. I consume a variety of healthy foods rich in protein fiber or calcium everyday e*g* white meat fish fruits vegetables milk soy products. 4. I go out with my family or friends at least once a week. 5. I pursue my hobbies at least once a week. 6. I have skills for coping with stress. 7. I frequently monitor my health e*g* blood pressure blood sugar body weight. 8. I frequently get quality sleep and rest. 9. I engage in my religious/spiritual activities at least once a week. 10. I frequently avoid those foods high in fat cholesterol sodium or sugar e*g* red meat butter eggs canned soup desserts. before buying/eating them* 12. I exercise more than twice a week. 13. I engage in activities in my community e*g* attending senior center volunteering at least once a week. promotion through the mass media health practitioners or classes/clubs. TV sitting and reading. For detailed information about the use of this screening tool please refer to the HELP Guide for Clinicians. Yes No 1. I spend sufficient time taking good care of myself e*g* grooming showering cooking house cleaning. 2. I avoid health-risk behaviors e*g* excessive drinking smoking consuming over-the-counter drugs. 3. 2. I avoid health-risk behaviors e*g* excessive drinking smoking consuming over-the-counter drugs. 3. I consume a variety of healthy foods rich in protein fiber or calcium everyday e*g* white meat fish fruits vegetables milk soy products. I consume a variety of healthy foods rich in protein fiber or calcium everyday e*g* white meat fish fruits vegetables milk soy products. 4. I go out with my family or friends at least once a week. 5. I pursue my hobbies at least once a week. 4. I go out with my family or friends at least once a week. 5. I pursue my hobbies at least once a week. 6. I have skills for coping with stress. 7. I frequently monitor my health e*g* blood pressure blood sugar body weight. 6. I have skills for coping with stress. 7. I frequently monitor my health e*g* blood pressure blood sugar body weight. 8. I frequently get quality sleep and rest. 9. I engage in my religious/spiritual activities at least once a week. 8. I frequently get quality sleep and rest. 9. I engage in my religious/spiritual activities at least once a week. 10. I frequently avoid those foods high in fat cholesterol sodium or sugar e*g* red meat butter eggs canned soup desserts. 10. I frequently avoid those foods high in fat cholesterol sodium or sugar e*g* red meat butter eggs canned soup desserts. before buying/eating them* 12. I exercise more than twice a week. 13. I engage in activities in my community e*g* attending senior center volunteering at least once a week.

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