Uncommon Sense Health Questionnaire


    Name:

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    1. Do you move your body for at least 30 minutes every day?
    YesNo


    2. What intensity do you mostly train at?
    90% MHR or 9-10 RPE70-90% MHR or 7-9 RPE60-70% MHR or 6-7 RPE60% MHR or 5 RPE or less

    MHR = Maximum Heart Rate
    RPE = Rating of Perceived Exertion – 1 to 10 scale how hard does your exercise feel with 1 being very easy and 10 being very hard


    3. Do you have any pain?
    Yes, at momentYes, in the last yearNo


    4. Is your exercise enjoyable?
    Yes, alwaysYes, mostlyYes, sometimesNo


    5. How often are you barefoot?
    NeverOccasionallyAs much as possible


    6. What do you wear when exercising?
    Conventional trainersMinimalist shoesBarefoot


    7. Do you have a repetitive strain and/or sporting injury?
    YesNo


    8.Have you been on a calorie-restriction diet before?
    Yes, 5 times or moreYes, 2-4 timesYes, onceNever


    9. Do you know how food makes you feel?
    YesNo


    10. Do you feel hyperactive and/or lethargic during the day?
    YesSometimesNo


    11. Do you eat carbohydrates on their own eg sweets, cakes and biscuits?
    YesRarelyNo


    12. Does you eat processed food?
    Often/everydayOccasionallyRarely


    13. What meat, fruit and vegetables do you generally buy?
    Organic / grass-fed/ traditional / seasonalThe best lookingStandard supermarketThe cheapest


    14. Do you avoid eating fat?
    YesNo


    15. Do you fast (go for lengths of time without food)?
    Yes, regularlyYes, occasionally overnight for 12+ hoursNever


    16. How many hours sleep a day you generally get?
    8 or moreAbout 7Fewer than 6


    17. Do you meditate, do Yoga, Tai Chi or similar?
    Every day5 times per week1-4 times per weekNo


    18. How much time do you spend outside each day in daylight?
    5 or more hours1-4 hours1 hour20 minutesNone


    19. Do you get ill when you have a holiday?
    Yes, oftenYes, sometimesNo


    20. Do you feel tired when you stop doing things?
    YesNo


    21. How many cups of tea/coffee do you have a day?
    3 or more1-2 before 3pmNone


    22. What is your measurement around your middle (tummy button level)?
    Over 100cm85-100cmUnder 85cm


    23. Do you take any prescription or over the counter medicines?
    Yes, everydayOccasionallyNo


    24. Are you sensitive to pollutants?
    YesSometimesNo


    25. Hydration – how much do you drink?
    2-4 litres per day of filtered water and non-caffeinated teasFewer than 2 litres per day of filtered water and non-caffeinated teasGenerally only tea, coffee, alcohol, carbonated & sugary drinks


    26. Are you aware that your body and your life situation is of your choosing?
    YesNo


    27. What percentage of your thoughts are negative?
    Over 80%Over 50%Under 50%Under 30%0%


    28. Is your closest relationship where you want it to be?
    YesNoWorking on it


    29. Do you love yourself?
    YesMaybeNo


    30. Do you have your dream/legacy written down?
    YesNo


    31. Do you have your values written down?
    YesNo


    32. Are you happy?
    Yes, generallySome of the timeOnly occasionally


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