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Personal Wellness Assessment

Thanks for taking our survey. Before we can create your custom plan, we need to ask you a few questions. Let’s get started.

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1. How many cigarettes do you typically smoke per day? (1 pack = 20 cigarettes)
2. How many times have you tried to quit smoking?
3. Smoking relaxes me and gives me pleasure.
4. I tend to smoke when I get angry, irritated, sad, or worried.
5. When I haven’t smoked for a while, I get a real craving for a cigarette.
6. I can smoke without even knowing I’m doing it.
7. Being healthy, preventing illness, or living longer:
8. Being a better role model for my kids or others: