Name Email Phone WHAT’S YOUR ENERGY & BLOOD SUGAR SCORE? What’s Your Energy & Blood Sugar Score? Use this questionnaire to rate your current energy levels, with 1 being you strongly disagree with the statement and 5 being you strongly agree. Indicate your rating by selecting the corresponding fields. Your final score is the sum total of each question's score (rating). 1. I often feel too tired to exercise 1 2 3 4 5 None 2. I often over-react to stress 1 2 3 4 5 None 3. I have less energy than I used to 1 2 3 4 5 None 4. I still feel tired 20 minutes after getting up 1 2 3 4 5 None 5. I need tea, coffee, a cigarette or something sweet to get me going in the morning 1 2 3 4 5 None 6. I often crave chocolate, sweet foods, bread, cereal or pasta 1 2 3 4 5 None 7. I often have energy slumps during the day or after meals 1 2 3 4 5 None 8. I often crave something sweet or coffee after meals 1 2 3 4 5 None 9. I often have mood swings or diffculty concentrating 1 2 3 4 5 None 10. I get dizzy or irritable if I go 4-6 hrs without food 1 2 3 4 5 None 11. I am gaining weight and/or finding it harder to lose weight 1 2 3 4 5 None Time's up Share Post Twitter Facebook VK Pinterest Mail to friend Linkedin Whatsapp Skype How Balanced Is Your Life?
