Lifestyle Survey

A quick lifestyle survey

Please fill in as many answers as possible

Your Measurements

Height (cm or ft)

Weight (kg)

Age

Gender

Smoking Status

Do You Smoke?

Alcohol Intake

How often do you have a drink containing alcohol?

Exercise Status

Do you Exercise Regularly?

Diet Type

Does your diet include fruits and vegetables?

Mental health

If you feel worried or anxious about something, do you have someone to talk to such as a friend, family or a mental health professional?

What do you think would help you lead a more healthy and balanced lifestyle? Please share any points.

Physical health

Have you taken part in any local or national health campaigns in the last 12 months such as dry January or Stopover?

In the last 12 months, have you increased the amount of walking you do?

How do you commute to work?

Mindfulness Activities

Are you aware of any local or national mindfulness activities such as educational days or mindfulness group activities?

In the last 12 months, have you taken part in any local or national mindfulness activity?

Long Term Medical Conditions

Do you take regular medication for any long-term medical condition?

Fully registered and GPhC regulated online pharmacy

Trustcare Pharmacy is fully registered with GPhC as an online pharmacy. You can check the registration status of our pharmacy and the superintendent pharmacist by following the links in the footer of the website.

Contact Us

All prescriptions are assembled, dispensed and supplied from the following location.