EVERSHINE QUIZ4U
SEASONAL PATTERN ASSESSMENT
Note: Information submitted is used
for statistical purposes only,
personal results are kept private, and not shared with any 3rd parties.
Please fill in all the relevant items.
Note: Answer for yourself, not someone else.
If you think others can benefit from this process,
email everyone a link to this page! |
| Name (Last, First MI) |
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| E-Mail Address |
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Want to receive an
email
analysis of your results? |
Yes
No |
| Birth City, State (if US) |
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| Birth Country |
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| Current City, State (if US) |
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| Current Country |
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| Years in Current Climate |
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| Current Height (feet/inches) |
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| Current Weight (pounds) |
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| Current Age (years/months) |
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| Occupation |
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| Level of Education |
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| Gender |
Male
Female
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| Marital Status |
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The purpose
of the following section is to find out how
your mood and behavior change over time.
To what degree do the following change with the seasons?
Click +
if more/better ~ Click -
if less/worse ~ Click neither if No Change
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This section: In Spring & Summer when days grow LONGER
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| Sleep Length |
+
-
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| Sleep Quality |
+
-
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| Social Activity |
+-
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Mood
(overall feeling of well being) |
+- |
| Weight |
+-
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| Appetite |
+-
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| Energy Level |
+-
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This section: In Fall & Winter when days grow SHORTER
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| Sleep Length |
+
-
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| Sleep Quality |
+
-
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| Social Activity |
+-
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Mood
(overall feeling of well being) |
+- |
| Weight |
+-
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| Appetite |
+-
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| Energy Level |
+-
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For the following situations, check all applicable months.
It may be a single month, a cluster of months or any other grouping. |
Gain most weight
*Check ALL applicable Months! |
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Socialize most
*Check ALL applicable Months! |
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Sleep Least
*Check ALL applicable Months! |
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Eat most
*Check ALL applicable Months! |
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Lose most weight
*Check ALL applicable Months! |
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Socialize least
*Check ALL applicable Months! |
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Feel Worst
*Check ALL applicable Months! |
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Eat Least
*Check ALL applicable Months! |
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Sleep Most
*Check ALL applicable Months! |
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Do you notice a change in food preference
during the different seasons? |
Yes
No |
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If yes... specify: |
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If you experience seasonal changes, do
you feel that these are a problem for you? |
Yes No |
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If yes... please rate:
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Content on EverShine4U.com is for information only and is not intended as a substitute for professional medical advice from your personal physician. Never try to disagnose, start or stop a diet, treatment, or other health care program from any website - without adequate consultation with the health care professional who is most familiar with your specific medical conditions. |
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