Preparation Stage
Question #5:
Am I Free?

Habit-Related
Health Risk Assessment

Answer the questions below on your Habits worksheet by giving yourself a grade (A, B, C, D, F) for the degree to which you fall short of the optimal health behavior. Indicate which criteria apply to your lifestyle. Your responses will help you determine how free you are from these potentially unhealthy habits.
1. Rest: Do you get restful sleep each night?
  • Do you sleep 7-8 hours per 24-hour cycle?
  • Are your sleep hours consistent night-to-night?
  • ​Do get sleepy during the day?
2. Water: Do you drink plenty of pure water every day?
  • Plenty = Weight / 2 = Ounces of Pure Water per Day
  • More if you do heavy labor, exercise, or eat lots of meat.
3. Air: Do you breathe fresh air every day?
  • Do you frequently take several deep breaths to completely fill and empty your lungs?
  • Do you maintain a proper posture and breathe normally using your diaphragm (belly-breathing)?
  • Do you keep your home, workspace, and bedroom at night well ventilated?
  • Do you frequently spend time outside in your yard gardening or exercising at a local park?
  • Do you spend a day each week in "the great outdoors" like at a beach or in the mountains?
4. Sunlight: Do you spend enough time outside to get enough sunlight?
  • How many daylight hours do you spend outside per week?
  • What time of day do you spend outside?
  • What areas of your body are exposed to sunlight?
  • Do you take Vitamin D supplements?
5. Temperance: Is there anything over which you want to have greater self-control?
  • Use of Drugs, Tobacco (nicotine), Alcohol, Caffeine, (coffee, tea, soda, energy drinks)?
  • Prescription or Over-the-Counter Medication, Dietary Supplements, Health Hacks?
  • Gambling, Shopping, Sex/Porn, TV, Movies, Social Media, Video Games, Cleaning?
  • Food, Ice Cream, Doughnuts, Pastries, Cakes, Pies, Cookies, Chips, Chocolate, Candy?
  • Politics, News, Sports, Religion, Music, Hobbies, Reading, Gossiping, Drama?
  • Work, School, Organization, Time, Money, Marriage, Parenting, Elder Care?
Identify and describe your most unhealthy habit (or the habit you most want to change): 

What?   When?   Where?   How?   Why?