“If You're Beginning to Slow Down, get Tired Easily and have More Aches and Pains Then you May Be Aging to Fast ...”

1)	Do you smoke or have been a smoker in the past or have been exposed to passive smoking?
		Yes
		No
		Yes But Now I've Quit

2)	Do you have bad hair or nails?
		Yes
		No

3)	Do you a cholesterol level above 5.2?
		Yes
		No

4)	Do you get enough sleep or have trouble sleeping?
		Yes
		No

5)	Do you have a poor memory for details, appointments or names?
		Yes
		No

6)	Do you eat enough vegetables?
		Yes
		No

7)	Do you have blood pressure problems?
		Yes
		No

8)	Do you worry about your family health history?
		Yes
		No

9)	Catch colds and flu easily?
		Yes
		No

10)	Like junk food?
		Yes
		No

11)	Often avoid exercising?
		Yes
		No

12)	Use household cleaners and cosmetics?
		Yes
		No

13)	Take prescription drugs?
		Yes
		No

14)	Live near a town or city with heavy traffic?
		Yes
		No

15)	Drink tap water?
		Yes
		No

16)	Do not drink red wine?
		Yes
		No

17)	Are you age 35 or over?
		Yes
		No