Health Inventories

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 
Please read our Terms of Use and Privacy Notice before you explore our Web site. To report a technical problem with this Web site, please contact Technical Support.
 
Chapter 10
Safety and the Environment How Safe Are You?

Rate your concern for safety. Read each statement below. Select always, sometimes, or never for each item. After completing the inventory, click on the How Did I Rate? button to display a printable version of your answers and to find out your score.

      
  1.I avoid behaviors and activities that lead to injuries.  
       a  always      b  sometimes      c  never        
      
  2.If I have to get something off a high closet shelf, I use a step stool.  
       a  always      b  sometimes      c  never        
      
  3.My family makes sure there is a working smoke alarm on every floor of our home.  
       a  always      b  sometimes      c  never        
      
  4.The members of my family avoid smoking in bed.  
       a  always      b  sometimes      c  never        
      
  5.If there is a gun in my home, it is kept in a locked cabinet and the bullets are stored separately. (If there is no gun in your home, mark this statement always.)  
       a  always      b  sometimes      c  never        
      
  6.I wear a safety belt when I'm riding in a motor vehicle.  
       a  always      b  sometimes      c  never        
      
  7.I wear a helmet when I ride my bicycle or go skating.  
       a  always      b  sometimes      c  never        
      
  8.I obey traffic signals.  
       a  always      b  sometimes      c  never        
      
  9.When I'm home alone, I don't open the door to anyone I don't know.  
       a  always      b  sometimes      c  never        
      
  10.When I leave my home, I tell my family my destination, route, and expected time of return.  
       a  always      b  sometimes      c  never        
      
  11.I refuse to get into or go near a stranger's car.  
       a  always      b  sometimes      c  never        
      
  12.I resist peer pressure and avoid giving in to friends who want to take careless chances.  
       a  always      b  sometimes      c  never        

Personal Wellness Contract