SPONSOR
OUR SITE

Physical Activity Rating 

Complete the following questionnaire to obtain a rating for your level of physical activity.

 Do you take the stairs instead of the lift?
Always
Sometimes
Never
Do you ever walk or ride a bike instead of driving?
Always
Sometimes
Never
Do you ever go for a walk at lunchtime?
Always
Sometimes
Never
How many organised sport activities do you participate in?
3 or more
2
1
0
How many hours per week would you spend participating in organised team, individual sport or physical activity?
More than 2 hours
One to two hours
Less than one hour
Zero
How many days per week would you exercise moderately for at least 30 minutes? (Moderate exercise means energetic activity that does not leave you out of breath)
Every day
Almost every day
2-3 days per week
Once a week
Rarely or never
How many days per week would you exercise vigorously for a minimum of 20 minutes?
Every day
Almost every day
2-3 days per week
Once a week
Rarely or never
How would you describe the activity levels in your daily occupation?
Highly active
Moderately active
Slightly active
Sedentary
How would you describe the activity levels in your overall lifestyle?
Highly active
Moderately active
Slightly active
Sedentary
If you had a spare afternoon, would you most likely (tick one response only);
play a high intensity sport (eg: tennis, squash, aerobics, running, cycling)
play a moderate intensity sport (eg: golf, bowling, lawn bowls)
go for a walk
do housework/domestic chores
gardening
read a book
sit and relax
sleep

Personal Information (Required)

Gender   Male Female
Age Group  
Country  
Postcode
(Australia Only)		  
Have you completed this survey before? Yes No

References:

Khomko, N., Ling, M., Nguyen, T., Ong, K., Su, S., Hsu-Hage, B., Healthy Eating & Healthy Living, Prevention of Diabetes, for women with a history of diabetes in pregnancy. Melbourne: Chinese Health Foundation of Australia, 1998.

 
 
© 2003-2004 Healthy Eating Club. About us. Disclaimer. Contact: Webmaster.
Mailing address: Healthy Eating Club Pty Ltd, Emerald Hill Clinic,
157 Clarendon St, Southbank, Victoria, Australia, 3006
tel: (03) 96906527 fax: (03) 96994474