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? (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