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  1. Home
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  4. Health and Wellness Survey
Survey

Health and Wellness Survey 2026

The Health and Wellness Survey opens by asking respondents to self-rate their general health before moving through seven questions covering diet, alcohol consumption, smoking status, physical activity, sleep quality, and stress levels — building a full picture of daily lifestyle habits in a logical order. The dietary question is open-ended so respondents can describe their habits in their own words, while the structured single-choice and rating questions that follow make patterns easy to compare across responses. Sleep quality and stress are placed last as paired ratings, since both reflect the cumulative effect of the lifestyle habits covered earlier. After submitting, respondents see a confirmation screen thanking them and noting that their answers will feed directly into their health assessment and personalized care planning.

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This template is ideal for

General practitioners

The "How would you describe your current general health?" question combined with the smoking, alcohol, and activity questions gives GPs a quick pre-appointment lifestyle baseline without taking up consultation time.

Workplace wellness coordinators

The paired sleep quality and stress rating questions let coordinators identify which wellbeing areas — rest or stress management — most need attention across their workforce.

Dietitians and nutritionists

The open-ended "Please describe your typical daily dietary habits and food consumption." question gives practitioners the detailed, individualized dietary context they need before a first consultation.

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Everything you need to create amazing forms

Smart Field Detection
Automatically detects and suggests the best field types for your data.
Real-time Validation
Validate responses as users type with instant feedback and error messages.
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Forms work seamlessly across desktop, tablet, and mobile devices.
Advanced Analytics
Track form performance with detailed analytics and response insights.

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