My Health Planning
My Care Health Planning Form. Please Provide Your details will help us to make your health plan.
Email address *
My Name *
Your answer
My Phone Number *
Please write your 10 digit mobile number (Don't add 0 or +91 as prefix)
Your answer
My Registration Date *
Please mention month & year of your registration with My Care. (Example: January 2016)
Your answer
1. I maintain a desirable weight. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
2. I engage in vigorous exercises such as brisk walking. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
3. I do exercises designed to strengthen my muscles and joints. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
4. I warm up and cool down by stretching before and after vigorous exercise *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
5. I feel good about the condition of my body. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
6. I get 7-8 hours of sleep each night. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
7. My immune system is strong and I am able to avoid most infectious diseases. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
8. My body heals itself quickly when I get sick or injured. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
9. I have lots of energy and can get through the day without being overly tired. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
10. I listen to my body; when there is something wrong, I seek professional advice. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
1. When I meet people, I feel good about the impression I make on them. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
2. I am open, honest, and get along well with other people. *
Please share your valuable suggestions, if you have, for Improvement in My Care Syatem
3. I participate in a wide variety of social activities and enjoy being with people who are different than me. *
4. I try to be a "better person" and work on behaviours that have caused problems in my interactions with others. *
5. I get along well with the members of my family. *
6. I am a good listener *
7. I am open and accessible to a loving and responsible relationship. *
8. I have someone I can talk to about my private feelings. *
9. I consider the feelings of others and do not act in hurtful or selfish ways. *
10. I consider how what I say, might be perceived by others before I speak. *
1. I find it easy to laugh about things that happen in my life. *
2. I avoid using alcohol as a means of helping me forget my problems. *
3. I can express my feelings without feeling silly. *
4. When I am angry, I try to let others know in non-confrontational and non-hurtful ways. *
5. I am a chronic worrier. *
6. I recognize when I am stressed and take steps to relax through exercise, quiet time, or other activities. *
7. I feel good about myself and believe others like me for who I am. *
8. When I am upset, I talk to others and actively try to work through my problems. *
9. I am flexible and adapt or adjust to change in a positive way. *
10. My friends regard me as a stable, emotionally well-adjusted person. *
1. I find it easy to laugh about things that happen in my life. *
2. I take time to enjoy nature and the beauty around me. *
3. I take time alone to think about what's important in life - who I am, what I value, where I fit in, and where I'm going. *
4. I have belief in the importance of things beyond myself. *
5. I engage in acts of caring and good will without expecting something in return. *
6. I feel sorrow for those who are suffering and try to help them through difficult times. *
7. I feel confident that I have touched the lives of others in a positive way. *
8. I work for peace in my interpersonal relationships, in my community, and in the world at large. *
9. I am content with who I am. *
10. I go for the gusto and experience life to the fullest. *
1. I tend to act impulsively without thinking about the consequences. *
2. I learn from my mistakes and try to act differently the next time. *
3. I follow directions or recommended guidelines and act in ways likely to keep others and myself safe. *
4. I consider the alternatives before making decisions. *
5. I am alert and ready to respond to life's challenges in ways that reflect thought and sound judgment. *
6. I tend to let my emotions get the better of me and I act without thinking. *
7. I actively try to learn all I reasonably can about an issue before making decisions. *
8. I manage my time well, rather than time managing me. *
9. My friends and family trust my judgment. *
10. I think about my self-talk (the things I tell myself) and then examine the real evidence for my perceptions and feelings. *
1. How often do you worry about your finances? *
2. Which of the following best describes your commitment to your financial health? *
3. How much stress do you feel about your finances? *
4. Have you viewed your credit report in the past 12 months, and do you know your credit score? *
5. In an emergency, do you have on hand, or do you know at least one person who could loan you at least INR 1,00,000 on a short term basis? *
6. How are you managing in meeting your current monthly expenses? *
7. Have there been any changes in your household income in the past 6-12 months? *
8. Is the total of all of your monthly debt payments (housing, student loans, car loans, credit card payments, rent to own contracts, etc) equal to or greater than 50% of your monthly income? *
9. Are your payroll tax withholding's (W-4) accurate, up-to-date & benefiting your monthly bottom line? *
A copy of your responses will be emailed to the address you provided.
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