HealthIntakeForm | Fab Over 40

Do you

Eat when you are bored?

Eat when you are stressed?

Have difficulty with portion control?

Stress: Check any symptoms below that apply to you:

Minor problems throw me for a loop

I am unable to stop thinking about my problems

I feel frustrated, impatient and angry much of the time

I feel tense and anxious much of the time

I have difficulty managing my time, such as work, family, meals, etc

What have been some of the health challenges/obstacles that you encountered in the past? Check all that apply to you: