Workplace Wellness - Worksheet - I
We all desire optimal health however we don’t know how to achieve that. One of the reasons for that is we don’t know what actions will give us a perfect health. The first step in getting healthy is to identify the reasons behind our present-day health conditions. Using this worksheet, we will be able to identify many areas that need attention from us. Some of these practices might need special supervision, especially for those who are under medication or carry certain medical conditions.
The worksheet is designed on a numerical system where each section carries a specific score. After answering the questionnaire, the employees are supposed to add the scores for each section till they get their final results. The scores of first, second and third columns are marked as T1, T2, T3 respectively. The total score for that table Total = T1 + T2 + T3
Tobacco Use Table
| Smoking-related Actions |
Circle the appropriate score |
| I avoid smoking cigarettes |
4 |
1 |
0 |
| I avoid pipes and cigars |
2 |
1 |
0 |
| I avoid spit tobacco. |
2 |
1 |
0 |
| I avoid passive smoking |
2 |
1 |
0 |
| Total = T1 + T2 + T3 = |
T1 |
|
T2 |
|
T3 |
|
Alcohol and Other Drugs Table
| Alcohol-related Actions |
Circle appropriate score |
| I take less than 1 (women) or 2 (men) drinks daily |
4 |
1 |
0 |
| I avoid alcohol/drugs to deal with stress |
2 |
1 |
0 |
| I avoid alcohol during medications or pregnancies. |
2 |
1 |
0 |
| I follow directions with over-the-counter drugs. |
2 |
1 |
0 |
| Total = T1 + T2 + T3 = |
T1 |
|
T2 |
|
T3 |
|
Nutrition-related Table
| Nutrition-related issues |
Circle the appropriate score |
| I eat variety of foods as calorie intake |
3 |
1 |
0 |
| I limit saturated fat and trans fat in diet. |
3 |
1 |
0 |
| I avoid skipping meals. |
2 |
1 |
0 |
| I limit salt and sugar in diet |
2 |
1 |
0 |
| Total = T1 + T2 + T3 = |
T1 |
|
T2 |
|
T3 |
|
Exercise/Fitness Table
| Smoking-related Actions |
Circle the appropriate score |
| I do weekly moderate-intensity exercises. |
4 |
1 |
0 |
| I maintain a healthy weight. |
2 |
1 |
0 |
| I do weekly exercise for muscular strength |
2 |
1 |
0 |
| I spend leisure time in physical activities |
2 |
1 |
0 |
| Total = T1 + T2 + T3 = |
T1 |
|
T2 |
|
T3 |
|
Emotional Health Score
| Emotional Health Activities |
Circle the appropriate score |
| I have a job that I like |
2 |
1 |
0 |
| I can relax and express my feelings easily |
2 |
1 |
0 |
| I handle stress well. |
2 |
1 |
0 |
| I can share personal matters with friends |
2 |
1 |
0 |
| I can easily participate in group activities |
2 |
1 |
0 |
| Total = T1 + T2 + T3 = |
T1 |
|
T2 |
|
T3 |
|
Safety Table
| Safety Activities |
Circle the appropriate score |
| I wear safety belt while driving |
2 |
1 |
0 |
| I don’t drive under influence of drugs/ liquor |
2 |
1 |
0 |
| I obey traffic rules and speed limit |
2 |
1 |
0 |
| I read precautions for using appliances |
2 |
1 |
0 |
| I don’t use cell phone while driving. |
2 |
1 |
0 |
| Total = T1 + T2 + T3 = |
T1 |
|
T2 |
|
T3 |
|
Disease Prevention Table
| Disease Prevention Activities |
Circle the appropriate score |
| I know warning signals of heart attack, stroke. |
2 |
1 |
0 |
| I avoid over-exposing my skin to the sun |
2 |
1 |
0 |
| I get medical screening for blood pressure |
2 |
1 |
0 |
| I practice regular self-exams for cancer |
2 |
1 |
0 |
| Total = T1 + T2 + T3 = |
T1 |
|
T2 |
|
T3 |
|
What Your Scores Mean
| 9 and 10 |
You know the importance of health in life |
| 6 and 8 |
Your health is good there is room for improvement |
| 3 and 5 |
Your health risks are high |
| 0 and 2 |
Risks are at dangerous levels! |
