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HEALTH SURVEY
In the first part of the exercise you have a questionnaire that deals with health care and your involvement in health care. Please take a few minutes to answer the questions and express your opinions.
In the second part you have to watch a video and answer some questions.
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NAME AND SURNAMES
Your answer
Would you say that, in general, your health is…
Excellent
Very good
Good
Fair
Poor
Don’t know/Not sure
Clear selection
Have you suffered from any of the below diseases or illnesses?
Yes
No
Don't know
Asthma
Arthritis
High blood pressure
High cholesterol
Allergies
Measles
Constipation
Croup
Influenza
Rubela/German measles
Yes
No
Don't know
Asthma
Arthritis
High blood pressure
High cholesterol
Allergies
Measles
Constipation
Croup
Influenza
Rubela/German measles
Clear selection
In the past 30 days, have you had any physical pain or health problems that made it hard for you to do your usual activities such as driving, working around the house, or going to work?
Yes
No
I don't know
Clear selection
During a normal week, other than in your regular job, do you engage in any physical activity or exercise that lasts at least a half an hour?
Yes
No
Other:
Clear selection
Since you said yes, how many times do you exercise or engage in physical activity during a normal week?
Your answer
Where do you go to exercise or engage in physical activity?
Your answer
Since you said “no”, what are the reasons you do not exercise for at least a half hour during a normal week? You can give as many of these reasons as you need to.
Choose
My job is physical or hard labor
Exercise is not important to me.
I don’t have access to a facility that has
the things I need, like a pool, golf course, or a track.
I don’t have enough time to exercise.
I don’t know
Do you currently smoke?
Yes
No
Clear selection
How often do you catch a cold?
Your answer
How often do you go to the dentist?
Your answer
How often do you brush your teeth?
Your answer
Have you ever had a tooth pulled? your teeth drilled? cleaned?
Your answer
Have you ever worn braces on your teeth?
Yes
No
Clear selection
Watch the video. In which part of the body are blood clots normally formed?
Your answer
Deep Vein Thrombosis is very likely to happen in flights.
TRUE
FALSE
Clear selection
Where should you rest your feet when flying?
Your answer
The presenter advises to take exercises in all flights.
TRUE
FALSE
Clear selection
Lack of water makes your blood.......(2 words)
Your answer
Another name for compression stockings
Your answer
You should take an aspirin
the day before your flight
during the flight
for three days after the flight
All above answers are correct
Clear selection
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