HB LIVE Program: Pre-Program Questionnaire for participants of the Hormone Balance LIVE Program. Section 1:Name* First Last Email* Weight*Height*Waist measurement in inches*Hip measurement in inches*Fasting Glucose Level*Fasting Total Cholesterol Level*Fasting LDL Cholesterol Level*Fasting HDL Cholesterol Level*Fasting Triglycerides Level*Blood Pressure*Vitamine D Level*Ferritin Level*Section 2:The following questions ask how you feel about your quality of life, health, or other areas of your life. Please choose the answer that appears most appropriate. If you are unsure about which response to give to a question, the first response you think of is often the best one. Please keep in mind your standards, hopes, pleasures and concerns. We ask that you think about your life in the last four weeks.How would your quality of life?* 1 - Very poor 2 - Poor 3 - Neither poor nor good 4 - Good 5 - Very good How satisfied are you with your health?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied Section 3:The following questions ask about how much you have experienced certain things in the last four weeks.To what extent do you feel that physical pain prevents you from doing what you need to do?* 5 - Not at all 4 - A little 3 - A moderate amount 2 - Very much 1 - An extreme amount How much do you need any medical treatment to function in your daily life?* 5 - Not at all 4 - A little 3 - A moderate amount 2 - Very much 1 - An extreme amount How much do you enjoy life?* 1 - Not at all 2 - A little 3 - A moderate amount 4 - Very much 5 - An extreme amount To what extent do you feel your life to be meaningful?* 1 - Not at all 2 - A little 3 - A moderate amount 4 - Very much 5 - An extreme amount How well are you able to concentrate?* 1 - Not at all 2 - A little 3 - A moderate amount 4 - Very much 5 - Extremely How safe do you feel in your daily life?* 1 - Not at all 2 - A little 3 - A moderate amount 4 - Very much 5 - Extremely How healthy is your physical environment?* 1 - Not at all 2 - A little 3 - A moderate amount 4 - Very much 5 - Extremely Section 4:The following questions ask about how completely you experience or were able to do certain things in the last four weeks.Do you have enough energy for everyday life?* 1 - Not at all 2 - A little 3 - Moderately 4 - Mostly 5 - Completely Are you able to accept your bodily appearance?* 1 - Not at all 2 - A little 3 - Moderately 4 - Mostly 5 - Completely Have you enough money to meet your needs?* 1 - Not at all 2 - A little 3 - Moderately 4 - Mostly 5 - Completely How available to you is the information that you need in your day-to-day life?* 1 - Not at all 2 - A little 3 - Moderately 4 - Mostly 5 - Completely To what extent do you have the opportunity for leisure activities?* 1 - Not at all 2 - A little 3 - Moderately 4 - Mostly 5 - Completely How well are you able to get around?* 1 - Very poor 2 - Poor 3 - Neither poor nor good 4 - Good 5 - Very good How satisfied are you with your sleep?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with your ability to perform your daily living activities?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with your capacity for work?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with yourself?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with your personal relationships?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with your sex life?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with the support you get from your friends?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with the support you get from your friends?How satisfied are you with the conditions of your living place?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with your access to health services?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied How satisfied are you with your transport?* 1 - Very dissatisfied 2 - Dissatisfied 3 - Neither satisfied nor dissatisfied 4 - Satisfied 5 - Very satisfied Section 5:The following question refers to how often you have felt or experienced certain things in the last four weeks.How often do you have negative feelings such as blue mood, despair, anxiety, depression?* 5 - Never 4 - Seldom 3 - Quite often 2 - Very often 1 - Always Do you have any comments about the assessment? 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