Template 상담 양식 건강한 습관 설문지 템플릿

건강한 습관 설문지 템플릿

건강한 습관 설문지 템플릿

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20
Questions
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Healthy Habits Questionnaire Template

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1.
Which kind of breakfast do you usually have?[체크박스]
Cereal or pastries
Cooked breakfast (full English)
Coffee or tea only
Toast
Protein shake or smoothie
I skip breakfast
Other
2.
How often do you skip breakfast?[체크박스]
Never
3 times or less per week
More than 3 times per week
Always
3.
Do you feel hungry or tired before lunchtime?[체크박스]
Yes
No
4.
What do you typically eat for lunch?[체크박스]
Fast food or meal deal
Packed lunch or sandwich
Fruit or yogurt
Cooked meal or salad
5.
On average, how long do your meals last?[체크박스]
Less than 10 minutes
10–29 minutes
30–59 minutes
60 minutes or more
6.
How many times do you usually chew before swallowing?[체크박스]
Fewer than 10 times
10 to 19 times
20 to 29 times
30 times or more
7.
When is your last meal relative to bedtime?[체크박스]
Within 2 hours before sleeping
More than 2 hours before sleeping
8.
When do you stop eating during a meal?[체크박스]
When about 80% full
When completely full (100% satiety)
9.
If you want a drink other than water, which would you choose?[체크박스]
Green tea
Black tea or other tea
Coffee (without sugar)
Coffee (with sugar)
Juice (non-carbonated)
Carbonated drinks
10.
What do you use to sweeten food or drinks?[체크박스]
Sugar
Other sweeteners
11.
How often do you snack after dinner?[체크박스]
3 times or more per week
Less than 3 times per week
12.
How often do you exercise?[체크박스]
Never
1-2 times a week
3-4 times a week
5-7 times a week
Other
13.
Would you describe your weight as:[체크박스]
Underweight
Overweight
About right
Prefer not to answer
14.
Do you have any weight loss or health goals?[체크박스]
Yes
No
Maybe
15.
Which goals do you want to achieve?[체크박스]
Weight loss
Inch loss
Tone up
Build lean muscle mass
Get fitter
Other
16.
How would you describe your gender?[체크박스]
Male
Female
Non-binary
I would like to skip this question
Prefer to self-describe
17.
What is your age group?[체크박스]
18-29
30-39
40-50
Over 50
18.
Would you like to learn how we can help you reach your goals with a few small changes?[체크박스]
Yes
No
Maybe
*
19.
Name
20.
Phone Number
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Template instructions
건강한 습관 설문지 템플릿은 개인의 식단, 운동 및 일상 생활에 대한 정보를 수집하는 데 도움이 됩니다. 이 설문조사를 사용하여 건강한 행동을 평가하고, 개선이 필요한 영역을 식별하고, 학생, 고객 또는 환자의 목표 설정을 지원합니다.

이 무료 템플릿에는 아침 식사 습관, 식사 유형 및 기간, 간식, 음료 선택, 포만감 신호, 씹는 빈도, 운동 빈도, 체중 인식 및 건강 목표에 대한 질문이 포함되어 있습니다. 연령 및 성별과 같은 인구통계학적 항목과 연락처 필드를 통해 후속 조치를 취할 수 있습니다.

체육 교사, 피트니스 트레이너, 의료 서비스 제공자, 웰니스 프로그램 및 학교에 적합합니다. 문구를 사용자 정의하고, 브랜딩을 추가하고, 웹사이트에 양식을 삽입하거나 링크를 공유합니다. 진행 상황을 추적하기 위해 응답을 내보내거나 다른 도구와 통합할 수 있습니다. 모바일 장치에서 응답을 수집하고, 결과를 스프레드시트로 내보내거나, 100개 이상의 통합과 연결하여 워크플로를 자동화하고 후속 조치를 통해 더 나은 결과를 얻을 수 있습니다.

"이 템플릿 사용"을 클릭하여 오늘 건강한 습관 설문지를 맞춤화하고 시작하세요.

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