Name First Last Lifestyle Spinal Stressor Load Tool Is Chiropractic right for you? Calculate Your BMI For Adults Please upgrade to web browser that supports iframes to see this CDC widget. </div> BMI SCORE:Enter Your Calculated ScoreNormal (18.5-24.9)Overweight (25.0-29.9)Obese (30 and Above)ie. Your weight (179 pounds) is in the Normal category for adults of your height (5 feet, 11 inches).1) On average, over the past 30 days, I have supplemented with a MINIMUM of 1000 IUs of VITAMIN D3 per 18 kilograms/40 pounds of body weight the following number of DAYS per WEEK:012345672) On average, over the past 30 days, I have supplemented with a MINIMUM of 450 milligrams of EPA and 300 milligrams of DHA per 18 kilograms/40 pounds of body weight from an OMEGA-3 FISH OIL like COD LIVER OIL the following number of DAYS per WEEK (If you don’t supplement with Omega-3 at all, indicate your score as 0):012345673) On average, over the past 30 days, I have performed at least 30 minutes of AEROBIC exercise (e.g. brisk walking, hiking, biking, jogging, swimming, etc.) the following number of DAYS per week:*012345674) On average, over the past 30 days, I have performed SPINAL CONDITIONING exercises (exercises to strengthen spinal postural muscles) and SPINAL HYGIENE exercises (exercises to improve range of motion and posture ie. Y, T, L, M exercise the following number of DAYS per WEEK.*012345675) On average, over the past 30 days, I have performed RESISTANCE exercise sessions the following number of DAYS per WEEK:*0123+6) On average, over the past 30 days, I typically SIT at work/school, commuting, and during my leisure time for the following number of combined HOURS per DAY (only count the hour if you do NOT get up and take a spinal mobility break in that hour):*0123456789107) During my lifetime, I have suffered the following number of SIGNIFICANT SPINAL TRAUMAS or INJURIES (from falls, accidents, work or sport activities, etc.) that have resulted in neck or back pain, and/or the need to limit activities for more than one week and for which I did not receive at least 12 visits of acute chiropractic care in the the last 6 weeks following the injury/trauma:*01234+8) I have had a CHIROPRACTIC SPINAL HEALTH EXAM within the past 12 months.*TrueFalse9) I have had regularly following a professionally prescribed spinal health and fitness plan for the past number of months:*03691210) On average, over the past 30 days, I would rate my overall level of PSYCHOLOGICAL/EMOTIONAL STRESS as (0= very low, 10= very high:*012345678910+11) On average, over the past 30 days, I have consumed/used TOBACCO PRODUCTS (cigarettes, chewing tobacco, pipes, cigars) the following number of times per DAY:*01234+ Δ
