Lifestyle Questionnaire

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LIFESTYLE QUESTIONNAIRE

AGE: 17 GENDER: MALE


General Instructions: Kindly fill out the questionnaire by marking your answer according to
the rating scale given below. Please go through all the statements and ask for assistance in
case of doubts.

This data will solely be used for the purpose of research and the details shared here will be
kept confidential.
Strongly Agree Agree Neutral Disagree Strongly
1 2 3 4 Disagree
5

1. I do yoga in the morning to maintain a healthy lifestyle. (2)

2. I believe brushing my teeth twice a day is important for good hygiene. (1)

3. I tend to not have breakfast on weekdays. (4)

4. Regular exercise is not a must for me. (3)

5. Most of my free time is spent on my phone. (3)

6. I plan my next day before going to bed. (2)

7. I do not feel constantly stressed thinking about the work I have left unfinished. (5)

8. I sleep late and wake up early. (2)

9. On weekends, I do not like to go out or meet friends. (5)

10. After school/work, I do not feel exhausted or drained. (2)

11. I eat according to a balanced diet. (3)

12. When I’m faced with new opportunities I do not feel motivated to try them out. (5)

13. I have family members or friends in my life who support me when needed. (1)

14. I do not depend on others to do my chores. (1)

15. I have trouble sleeping at night. (5)

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