Table2
| # | Status | Date Submitted | Name | Cell Number | Date of Completion | 1. I engage in sweat-producing physical activity for 20-30 minutes at least three times per week. | 2. My physical activity includes stretching, aerobic activity and strength conditioning. | 3. I walk or bicycle as a means of transportation whenever possible. | 4. An integral part of my leisure time includes physical activity instead of TV viewing or surfing the Internet | 5. If I am not in shape, I avoid sporadic (once per week or less) strenuous exercise. (If you are in shape answer "Almost Always") | Score1 | Percent1 | 1. I avoid the use of tobacco products. (cigarettes, smokeless tobacco, cigars, pipes) | 2. I examine my breasts/testes on a monthly basis. | 3. I protect my skin from sun damage by using sunscreen, wearing hats, and/or avoiding tanning booths and sun lamps. | 4. I maintain my blood pressure within the recommended range. (If you do not have your blood pressure checked, answer "Almost Never") | 5. I floss my teeth every day. | Score2 | Percent2 | 1. I eat at least five servings of fruits and vegetables every day. (one serving equals one piece of fruit or 1/2 cup) | 2. I avoid eating at fast food restaurants. | 3. I intentionally include foods that are high in fibre in my diet on a daily basis. (i.e. whole grain breads and cereals, beans, etc.) | 4. I maintain my weight within the recommendations for my height and gender. | 5. I avoid eating foods that are high in fat (whole milk dairy products, fried foods, hot dogs, desserts, gravies, and fatty meats) | Score3 | Percent3 | 1. My sexual relationships and behaviours are maintained in a manner that is healthy for me and for others. | 2.I am able to develop close intimate, personal relationships. | 3. I am tolerant of others who have different sexual orientations. | 4. If I engage in sexual behaviours I take action to avoid unwanted pregnancy. (If you do not engage in sexual intercourse, answer "Almost Always".) | 5. I feel positive about myself as a sexual person. | Score4 | Percent4 | 1. I express my feelings of anger in ways that are not hurtful to others. | 2. I set realistic objectives for myself. | 3. When I make mistakes, I learn from them. | 4. I do not feel unreasonably hurried in my daily routine. | 5. I accept responsibility for my own actions. | Score5 | Percent5 | 1. I keep informed about social, political and/or current issues. | 2. I watch educational programs on television every week, (News, political discussions, documentaries public TV, or the Discovery channel). | 3. I seek opportunities to learn new things. | 4. Before making decisions, I gather all the facts. | 5. I participate in activities such as visiting museums, exhibits, and zoos, or attending plays and concerts at least three times a year | Score6 | Percent6 | 1. I feel that my life has a positive purpose. | 2. My leisure time activities are consistent with my values. | 3. My actions are guided by my own beliefs, rather than the beliefs of others. | 4 .I spend a portion of every day in prayer, meditation, and/or personal reflection. | 5. I am tolerant of the values and beliefs of others. | Score7 | Percent7 | 1. I regularly recycle my paper, plastic, glass or aluminium. | 2. My behaviour reflects fairness and justice. | 3. I take time to interact/play with my family and friends. | 4. When I notice something that is dangerous to others I take action to correct it. | 5. I contribute time and/or money to at least one organization that strives to better the community where I live. | Score8 | Percent8 | 1. I enjoy my work. | 2. I am satisfied with the balance between my work time and leisure time. | 3. I am satisfied with my ability to manage and control my workload. | 4. My work is consistent with my values. | 5. At work my level of authority is consistent with my level of responsibility. | Score9 | Percent9 | 1. I wear a seat belt when travelling in a vehicle. | 2. I stay within five km/miles per hour of the speed limit. | 3. I avoid riding with drivers who are under the influence of alcohol or other drugs. | 4. I avoid the use of alcohol and other drugs. | 5. I use the recommended safety equipment (pads, mouth guards, goggles, life jacket, etc.) for any activity I participate in. | Score10 | Percent10 | 1. I am comfortable leaving a balance in my savings account or credit card(s) | 2. I think it is important to spend less than I earn. | 3. I have enough money saved to handle financial emergencies. | 4. I track my spending to stay within my monthly budget. | 5. I am comfortable about my finances or the money I owe (overdraft, credit card, etc.) | Score11 | Percent11 | 1. I stop during the day to become aware of the way I am breathing. | 2. I have plenty of energy. | 3. I take time out for deep breathing several times a day. | 4. I am at peace with myself and my breathing is calm. | 5. I meditate or relax myself for at least 15 to 20 minutes each day. | Score12 | Percent12 | Scorefull | Final Score | |
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| 5 | Submitted | 15/10/2024 03:35 PM | pp pp | info@yoga.org.za | 45.435.456.456 | 15/10/2024 | Occasionally | Often | Very Often | Very Often | Very Often | 17,00 | 68 | Almost Always | Almost Never | Often | Very Often | Almost Never | 14 | 56 | Very Often | Often | Very Often | Occasionally | Often | 18 | 72 | Often | Almost Never | Often | Occasionally | Very Often | 13 | 52 | Occasionally | Often | Occasionally | Often | Occasionally | 12 | 48 | Occasionally | Often | Almost Always | Often | Almost Never | 14 | 56 | Often | Very Often | Almost Never | Often | Almost Always | 16 | 64 | Almost Always | Very Often | Often | Almost Always | Almost Always | 22 | 88 | Very Often | Very Often | Often | Occasionally | Almost Always | 18 | 72 | Almost Always | Often | Very Often | Very Often | Very Often | 20 | 80 | Often | Almost Always | Almost Always | Almost Always | Almost Always | 23 | 92 | Very Often | Often | Often | Almost Always | Almost Always | 20 | 80 | 207 | 69,00 |
