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How often do you exercise?
 
a. 0-1 times per week
 
b. 1-3 times per week
 
c. 3-5 times per week
 
d. 5 or more times per week
 
 
 
Why do you exercise?
 
a. To burn fat and calories
 
b. To get a cardio workout
 
c. To feel better
 
d. To reduce stress
 
e. All of the above
 
 
 
How would you rate your stress level?
 
a. Minimal-I feel stressed rarely.
 
b. Moderate-I feel stressed sometimes.
 
c. Extreme- I feel stressed often.
 
 
 
When you exercise have you noticed a reduction in your stress level?
 
A. Yes
 
B. No
 
 
 
Do you believe stress can cause health related illnesses
 
a. Yes
 
b. No
 
 
 
What is you current age range?
 
a. 35-40
 
b. 41-45
 
c. 46-50
 
d. 51-55
 
 
 
How would you rate your current health status?
 
a. Poor
 
b. Fair
 
c. Good
 
d. Excellent
 
 
 
What do you do to cope with stress?
 
a. Nothing
 
b. Exercise
 
c. Relaxation/Deep Breathing Techniques
 
d. Over indulge with food or alcohol
 
 
 
Do you think exercise reduces stress?
 
a. Yes
 
b. No
 
c. Maybe
 
d. Don't know
 
 
 
What is your highest level of education?
 
a. High school or GED
 
b. Some college
 
c. Bachelors degree
 
d. Post graduate degree
 
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