Ready to Reshape Your Life Survey
Time Elapsed:
0
minutes
Time Remaining:
0
minutes
Total Time:
0
minutes
Anonymous Login Code:
Save this code, which is required to update your response at a later time.
Are you ready to reshape your life? Take our quick survey to help gauge your readiness to enter our life-changing program.
Do either of the following statements apply to you?
(Note): You may use the link below to find your Body Mass Index (BMI).
I have a body mass index greater than or equal to 40.
OR
I have a body mass index of 35-39.9 and other obesity-related health problems such as, type 2 diabetes, high blood pressure, obstructive sleep apnea, or heart disease.
*
Determine your BMI
(A new window will open. You may close that window once you have finished to return to the survey)
Yes
No
© 2010 Eastern Maine Medical Center