Here’s a SayPro Health and Wellness Questionnaire that can be used as a pre-camp questionnaire to understand the participant’s current health habits, goals, and any dietary restrictions or preferences:

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SayPro Health and Wellness Pre-Camp Questionnaire

Thank you for taking the time to complete this questionnaire! Your responses will help us tailor the camp experience to your individual needs and goals.

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Personal Information:

1. Full Name:
2. Age:
3. Gender:
   [ ] Male
   [ ] Female
   [ ] Non-Binary
   [ ] Prefer not to say
   [ ] Other: _______________
4. Email Address:

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Current Health Habits:

5. How would you rate your current overall health?
   [ ] Excellent
   [ ] Good
   [ ] Fair
   [ ] Poor
6. How many days per week do you currently engage in physical activity (exercise, sports, etc.)?
   [ ] 0
   [ ] 1-2
   [ ] 3-4
   [ ] 5+
7. What type of physical activities do you currently enjoy or participate in?
   [ ] Walking
   [ ] Running/Jogging
   [ ] Yoga/Pilates
   [ ] Strength Training
   [ ] Swimming
   [ ] Team Sports
   [ ] Cycling
   [ ] Other: _______________
8. How many hours of sleep do you typically get each night?
   [ ] Less than 4 hours
   [ ] 4-6 hours
   [ ] 6-8 hours
   [ ] 8+ hours
9. On a scale of 1 to 10, how would you rate your current stress levels? (1 being very low, 10 being very high)
   [ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ] 6 [ ] 7 [ ] 8 [ ] 9 [ ] 10

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Diet and Nutrition:

10. How often do you eat fruits and vegetables each day?
    [ ] Never
    [ ] Rarely (1-2 servings)
    [ ] Sometimes (3-4 servings)
    [ ] Often (5+ servings)
11. How would you describe your current eating habits?
    [ ] I eat mostly whole, nutritious foods
    [ ] I eat a mix of healthy and unhealthy foods
    [ ] I mostly eat processed and convenience foods
12. Do you follow a specific diet or eating plan?
    [ ] Yes (Please specify): _______________
    [ ] No
13. Do you have any food allergies or intolerances?
    [ ] Yes (Please specify): _______________
    [ ] No
14. Do you have any dietary restrictions or preferences?
    [ ] Vegetarian
    [ ] Vegan
    [ ] Gluten-Free
    [ ] Dairy-Free
    [ ] Paleo
    [ ] Low-Carb
    [ ] Other (Please specify): _______________
    [ ] No dietary restrictions
15. How often do you consume processed foods, snacks, or sugary beverages (sodas, energy drinks, etc.)?
    [ ] Rarely
    [ ] Sometimes
    [ ] Often
    [ ] Daily
16. Do you currently track your food or meals (e.g., using an app or journal)?
    [ ] Yes
    [ ] No

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Health Goals:

17. What are your top health and wellness goals for attending the SayPro Camp? (Check all that apply)
    [ ] Improve physical fitness
    [ ] Lose weight
    [ ] Gain muscle or strength
    [ ] Improve flexibility and mobility
    [ ] Learn more about nutrition and healthy eating
    [ ] Reduce stress and manage mental health
    [ ] Increase mindfulness and self-awareness
    [ ] Build sustainable healthy habits
    [ ] Other: _______________
18. What challenges or barriers have you faced in achieving your health goals? (Check all that apply)
    [ ] Lack of time
    [ ] Lack of motivation
    [ ] Difficulty with meal planning or preparation
    [ ] Lack of knowledge about nutrition or fitness
    [ ] Lack of sleep or poor sleep habits
    [ ] Stress or emotional eating
    [ ] Other: _______________
19. How confident are you in your ability to maintain a healthy lifestyle long-term?
    [ ] Very confident
    [ ] Somewhat confident
    [ ] Neutral
    [ ] Not confident

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Mental and Emotional Health:

20. How often do you feel stressed or anxious?
    [ ] Never
    [ ] Rarely
    [ ] Sometimes
    [ ] Often
    [ ] Always
21. Do you currently practice mindfulness, meditation, or other stress-relief techniques?
    [ ] Yes (Please specify): _______________
    [ ] No
22. On a scale of 1 to 10, how would you rate your emotional well-being? (1 being very poor, 10 being excellent)
    [ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ] 6 [ ] 7 [ ] 8 [ ] 9 [ ] 10

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Additional Information:

23. Is there anything else we should know to better tailor the camp experience to your needs?

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Acknowledgment and Consent:

24. I acknowledge that the information provided in this questionnaire is accurate and complete to the best of my knowledge.
    [ ] I Agree
25. I consent to participating in the SayPro Health and Wellness Camp and understand that any information shared is confidential and used only to enhance my experience.
    [ ] I Agree

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Thank you for completing the SayPro Health and Wellness Pre-Camp Questionnaire! We look forward to supporting you on your wellness journey.

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This questionnaire will help camp organizers understand each participant’s health status, goals, and needs, enabling them to create a more personalized and supportive experience during the camp.