STARTING EVALUATION
StepOne StepTwo StepThree StepFour

Answer all of the questions below and click "Next"

OVER THE LAST MONTH, ON AVERAGE, HOW MANY DAYS PER WEEK DID YOU COMPLETE SOME PHYSICAL ACTIVITY?

HOW HAPPY ARE YOU WITH YOUR...

{{s.question}}

NOT HAPPY
VERY HAPPY
1: Not Happy 10: Very Happy

CURRENT WEIGHT AND WAIST SIZE

QUESTIONS/NOTES FOR YOUR DOCTOR

Next evaluation in {{nextEvaluation}} weeks

Set a reminder on your phone now and put it in your calendar

{{errorMessage}}

PP-NEB-ALL-0317-1

Last updated: 2019
G.MKT.GM.MH.02.2018.0506