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Health Survey
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Survey

Health Survey

Health Survey template with ready-made questions — customize, publish and start collecting responses in minutes.

9 fields Ready to publish

What's included

  • 1
    How would you rate your overall health?
    Excellent · Good · Fair · Poor
    RequiredDropdown
  • 2
    How often do you exercise?
    Daily · Weekly · Monthly · Rarely · Never
    RequiredDropdown
  • 3
    How many hours do you sleep per night?
    Less than 5 · 5-6 · 7-8 · More than 8
    RequiredDropdown
  • 4
    Do you smoke?
    Yes · No · Not sure
    RequiredDropdown
  • 5
    Do you have any chronic conditions?
    Yes · No · Not sure
    RequiredDropdown
  • 6
    List current medications (optional)
    Long text
  • 7
    Rate your stress level
    RequiredRating
  • 8
    Name (optional)
    Short text
  • 9
    Email (optional)
    Email

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