Background

Question 1 of 12 — Establishing your baseline life expectancy

Background

Question 2 of 12 — Establishing your baseline life expectancy

Female
Male

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Question 3 of 12 — Establishing your baseline life expectancy


Background

Question 4 of 12 — Establishing your baseline life expectancy

African American / Black
American Indian / Native American
Asian / Pacific Islander
Caucasian / White
Hispanic / Latino
Other / Multi-ethnic

Background

Question 5 of 12 — Establishing your baseline life expectancy

  • 4'
  • 4'6"
  • 5'
  • 5'6"
  • 6'
  • 6'6"
  • 7'
  • 7'6"
5'6" (168cm)

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Question 6 of 12 — Establishing your baseline life expectancy

Background

Question 7 of 12 — Establishing your baseline life expectancy

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Question 8 of 12 — Establishing your baseline life expectancy

What is your annual household income from all sources?

Less than $20,000
$20,000 to $25,000
$25,001 to $35,000
$35,001 to $50,000
$50,001 to $75,000
$75,001 to $150,000
More than $150,000

Background

Question 9 of 12 — Establishing your baseline life expectancy

What was the last year of school you completed?

Never attended school or only attended kindergarten
Grades 1 though 8 (elementary)
Grades 9 through 11 (some high school)
Grade 12 or GED (high school graduate)
College 1 year to 3 years (some college or technical school)
College 4+ years (college graduate)
Graduate school

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Question 10 of 12 — Establishing your baseline life expectancy

Have you smoked tobacco products in the last 5 years?

Yes
No

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Question 11 of 12 — Establishing your baseline life expectancy

If you smoke, how many times per day?

  • 0
  • 5
  • 10
  • 15
  • 20
  • 25
  • 30+
0 times

Background

Question 12 of 12 — Establishing your baseline life expectancy

Chronic Diseases

Have you ever been diagnosed with any of the following conditions? (Check all that apply.)