Health & Lifestyle Questionnaire

Healthy Lifestyle

By answering the following questions, this Health & Lifestyle Questionnaire becomes a tool to help you better understand your own lifestyle and its affects on your health. The questionnaire provides you with a starting point to act as a guide to help you make new and healthy lifestyle changes.

This questionnaire is only a rough screening for heart disease which helps in self-assessment and elicits the need to take precautionary measures for preservation of good health.

  • 01

    How old are you?

  • 02

    Are you male or female?

  • 03

    How would you describe you body and physical condition?

  • 04

    How many members of your family have a history of heart disease?

  • 05

    How often do you eat-out, consume junk food and fast-food?

  • 06

    In general, which type of foods do you mostly like to eat?

  • 07

    Do you a smoke cigarettes or have you used tobacco related products in the past?

  • 08

    Are you physically active and exercise regularly or do you have no exercise or irregular physical activity?

  • 09

    Have you had you blood cholesterol checked recently?

  • 10

    Have you had you blood pressure checked recently?

    Systolic Blood Pressure in mm/Hg

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Establishing a society where individuals learn and inculcate a scientific approach to build a healthy and holistic lifestyle.

Contact us now for your health consultation

 020 26161095
Latest News

    World Heart Day 2018
  • World Heart Day 2018

    Dr Manisha Bandishti celebrates World Heart Day 2018.

    World Heart Day is aimed at creating greater awarenes of heart illnesses and the associated health issues.

Health Assessment Tools

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Contact Information

Dr. Manisha Bandishti
Lifestyle for Health

303, 3rd floor, Choice ‘C’ Apartment
Opposite Millenium Star Building
Near Ruby Hall Clinic
Dhole Patil Road

T: 020 26161095
M: 7350530101