Follow the steps to fill out the Lifestyle Assessment Form.

1. Click ‘Get Form’ button to obtain the Lifestyle Assessment Form and open it in your preferred document editor.
2. Begin by entering your personal information, including your name, date, age, and sex. Ensure all details are accurate to aid in the assessment process.
3. Answer the questions concerning your purpose for visiting and your main health concerns. Clearly list your concerns in order of priority, as this will help prioritize your needs.
4. Provide insight into your stress levels by quantifying them on a scale of 1 to 10. Additionally, check all factors that contribute to your stress and describe how your stress manifests itself.
5. Detail your coping mechanisms and provide information on your exercise routine, including type, frequency, and duration.
6. Rate your energy levels on a scale of 1 to 10 and note any fluctuations throughout the day. Document your average sleep hours and any sleep issues you may have.
7. Fill out the sections regarding your current occupation, work hours, and whether you enjoy your job. Include information about your smoking habits and weight goals.
8. Complete the medical history section, including any medications you are taking and allergies you may have.
9. Answer questions related to your family medical history and provide dietary habits, detailing your typical meals and any food restrictions.
10. Review your responses to ensure accuracy and comprehensiveness. Sign the client statement to acknowledge the nature of the services offered.
11. Finally, save your changes. You may then choose to download, print, or share the completed Lifestyle Assessment Form as needed.

Complete your document online today to take a step toward better health!