This questionnaire is on your medical history, diet, activity levels, and possible obstacles to your weight management efforts. It aims to help you understand your needs and provide you with information of losing weight in a healthy way. There are no right or wrong answers, just select the options that best represent your views.
The questionnaire is conducted anonymously and it takes about 20 to 30 minutes to complete. Please note that if there is no action or movement on the page for 30 minutes or more, the session will expire and you need to redo the questionnaire from the beginning. At the end of the questionnaire, you can view the questionnaire summary and report, and obtain a copy of them via email.
Once you fill in the personal information, you will be assigned a reference number. The reference number will also be shown on your questionnaire summary and report. Please remember to keep your reference number for future reference.
- By completing the questionnaire, you agree to have your answers recorded for use in research if any. Your participation is completely voluntary, and all responses to this questionnaire are anonymous.
- The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
- This site is best viewed in Google Chrome.
Click below to begin the questionnaire