Sub-Health Assessment Survey Checklist 亚健康评估调查表

Please rate each statement on a scale of 1 to 5, with 1 being "Strongly Disagree" and 5 being "Strongly Agree."

请根据您的感受，在1到5的范围内对每个陈述进行评分，其中1表示“强烈不同意”，5表示“强烈同意”。

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Date of Survey  调查日期 *
MM
/
DD
/
YYYY
Gender性别 *
Age Range年龄层 *

I experience consistent fatigue or low energy levels.
我经常感到疲劳或精力不足。
Clear selection

My sleep quality is generally poor.
我的睡眠质量通常较差。
Clear selection

I often feel stressed or anxious.
我经常感到压力或焦虑。
Clear selection

I have difficulty maintaining a healthy weight.
我很难保持健康的体重。
Clear selection

My digestion is frequently problematic.
我的消化系统经常出现问题。
Clear selection

I experience frequent headaches or migraines.
我经常头痛或偏头痛。
Clear selection

I often have muscle or joint pain.
我经常感到肌肉或关节疼痛。
Clear selection

My immune system seems weaker than usual.
我的免疫系统似乎较弱。
Clear selection

I frequently have difficulty concentrating or have brain fog.
我经常难以集中注意力或感到思维迷糊。
Clear selection

I often experience mood swings or emotional instability.
我经常情绪波动或情绪不稳定。
Clear selection

I engage in regular physical activity and exercise.
我定期参加体育活动和锻炼。
Clear selection

I maintain a balanced and nutritious diet.
我保持均衡和营养丰富的饮食。
Clear selection

I have regular check-ups with a healthcare provider.
我定期接受医疗保健提供者的检查。
Clear selection

I actively manage stress through relaxation techniques or mindfulness.
我通过放松技巧或正念积极管理压力。
Clear selection

I am satisfied with my overall health and well-being.
我对我的整体健康和福祉感到满意。
Clear selection
Results of the sub-health assessment survey   
亚健康评估调查结果
Total Score 总分 15-30: Low sub-health risk ：低亚健康风险
Total Score 总分 31-45: Moderate sub-health risk ：中等亚健康风险
Total Score 总分 46-60: High sub-health risk 总分 ：高亚健康风险
Follow-up
后续行动
Encourage the individual to seek further evaluation or consultation with a healthcare professional if their sub-health status indicates a high risk or if there are specific health concerns identified in the survey.  
鼓励个体在亚健康状态显示高风险或在调查中识别出特定健康问题的情况下，寻求进一步评估或咨询医疗专业人员的建议。
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