Health Assessment - Hewale Lifestyle - Great health? That's HEWALE

1. SELECT YOUR GENDER

MALE FEMALE

2. WHAT ARE YOUR HEALTH GOALS

LOWER BLOOD PRESSURE LOWER CHOLESTEROL LOSE WEIGHT HEALTHY BLOOD SUGAR LEVELS REDUCED PAIN AND IMPROVED MOTION IN ARTHRITIS OTHER CHRONIC ILLNESS RELATED GOALS

3. ANY RELATIVES WITH HIGH BLOOD PRESSURE OR DIABETES?

Family History may play a role in chronic illness

YES NO I DON'T KNOW

4. DO YOU TAKE ANY CHRONIC MEDS OR SUPPLEMENTS?

We can help track your meds and supplements so you don't miss a dose

YES NO

5. DO YOU EXPERIENCE ANY OF THESE SYMPTOMS?

Select all that apply

Regular Stress Fatigue Headaches Difficulty Breathing Numbness Brain Fog

6. DO YOU EAT ANY OF THESE FOODS?

Select all that apply

DID YOU KNOW?

Foods high in sugar, saturated fats and sodium cause inflammation that worsens arthritis and puts you at risk of high cholesterol, high blood pressure and metabolic disorders including type 2 diabetes and obesity.

Hewale Lifestyle can help you with personalised plans that work for your health goals.

7. DO YOU HAVE ANY FOOD ALLERGIES/INTOLERANCE?

We will exclude these from your personalised health plan

8. HOW MANY MEALS DO YOU PREFER TO EAT DAILY?

We will curate your personalised health plan accordingly

3 meals 4 meals (3 meals and 1 snack) 5 meals (3 meals and 2 snacks)

9. HOW PHYSICALLY ACTIVE ARE YOU?

This will help us craft your personalised physical fitness plan

Lightly active (No workouts, sedentary lifestyle) Moderately active (Light workouts 1-2 times a week or similar activities eg. taking a walk) Very active (Workouts at least 3+ times a week or similar activities eg. manual labour job)

10. YOUR BIOMETRIC DATA

Your age, weight and height help us assess your rate of metabolism and BMI

AGE (years):

HEIGHT (cm):

WEIGHT (kg):

ALL DONE!

At Hewale Lifestyle we know healthcare is not a once-a-month visit to the pharmacy or doctor's office, but daily activity culminating in great health.

Start your personalised journey, with our holistic support, to managing and reversing chronic illness including obesity, arthritis, high cholesterol, diabetes and hypertension.

Enter your first name and contact info below to receive your results and see how our services can help you.

Great health? That's HEWALE!

FIRST NAME:

EMAIL:

PHONE NUMBER:

Hewale Lifestyle Health Assessment