1 - How old are you? Write your age in numbers: 2 - How long would you like to live? 80 years || 100 years || 120 years || 150 years || Forever 3 - Your body build is: Skinny || Athletic || Normal || Heavy 4 - How many times do you get drunk monthly? 0 || 1 || 2-3 || 4 + 5 - How many times do you binge-eat in a month? 0 || 1 || 2-3 || 4 + 6 - How many times do you eat meat in a week? 0 || 1 || 2-3 || 4 + 7 - How many times do you eat seafood weekly? 0 || 1 || 2-3 || 4 + 8 - Do you trust strangers? No || Not much || Enough || Much 9 - Do you like to try extreme sports? No || Not much || Enough || Very much
10 - Do you possess firearms? Yes || No 11 - What educational qualification do you possess? Less than high school diploma || High school diploma || Bachelor's degree Master's degree or better 12 - How many books do you read yearly? 0 || 1-2 || 3-6 || 7 + 13 - How long do you wait between a blood analysis and the following one? Few months || A year || Two years || More than two years 14 - How much time do you spend on roads weekly? (car, motorcycle , bus, bicycle, etc.) 1 || 2-4 || 5-9 || 10 + 15 - How many cigarettes do you smoke daily? I've never smoked || I smoked in the past || 1-3 || 4-9 || 10 + 16 - Do you take drugs? In the past || Yes || No 17 - Is your blood pressure high? Yes || No 18 - Is your cholesterol level high? Yes || No 19 - Has any of your relatives had a heart attack? No || Yes, before 50 years of age || Yes, after 50 years of age 20 - Has your family ever had cases of neurodegenerative diseases? (for example: Alzheimer's disease or Parkinson's disease) No || Yes, one case || Yes, more than one case 21 - Do you play any sports? No || Sometimes || Regularly 22 - How many enemies do you have? 0 || 1 || 2-3 || 4 + 23 - Have you ever caused accidents? (car crashes or work accidents) Never || Once || Twice or more 24 - Are you an impulsive person? (do you easily get angry?) No || Sometimes || Frequently 25 - Have you ever committed crimes? (thefts, fights, vandalisms, drug trafficking) No || Once || Twice or more 26 - Are you an insecure person? (undecided, easily frightened, passive) No || Sometimes || Frequently 27 - How many friends do you have? 0 || 1 || 2-3 || 4 + 28 - Have you ever cheated on your partner? No || Once || Twice or more 29 - Do you like your job? No || Not much || Enough || Very much 30 - How many times do you get sick yearly? 0 || 1 || 2-3 || 4 + 31 - Have you ever desired to die? Never || Once || Several times || Frequently 32 - You have been feeling an annoying pain in your chest during the past days. What do you do? You wait for the pain to pass || You try not to think about it || You call your doctor for a check up 33 - Do you drink wine, beer or other alcoholic beverages? In the past || No || Sometimes || Every day 
