Sleep Duration: Sleep Quality: Family Longevity & Genetics: Smoking & Tobacco Use: Alcohol Consumption: Processed Food & Sugar Intake: Produce Quality: Environmental Toxin Exposure: Resistance & Weight Training: Cardiovascular Exercise: Mindfulness & Stress Reduction: Stress & Mental Health: Social Support Network: Proactive Self-Care & Preventative Health: Cosmetics & Skin Care: Metabolic Health: Non-Stick Cookware Use: Omega-3 Intake: Cooking Oils Preference: Chronic Conditions (Select all that apply):

Cancer

Stroke

Heart Disease

Type 2 Diabetes

COPD

Kidney Disease

Hypertension

Arthritis

Asthma

Depression

Dental & Oral Health: Cold Exposure & Heat Therapy: Posture & Movement (Sedentary Lifestyle): Hydration Amount (cups/day): Do you drink filtered water? Do you mainly drink bottled water? Processed Sugary Drinks:

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Longevity isn’t just about adding years—it’s about adding life to your years. Our Wellness Pathways program helps you optimize your health through nutrition, movement, sleep, and stress management.

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SHIFT ETHOS

7659 Mall Rd.
Florence, Ky. 41042

support@shiftethos.com

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