Q.1
To what age do you expect to live? *

Q.2
How do you feel compared to your chronological age? *

Q.3
What are the top two things you're doing to fight aging? *

Q.4
What’s left on your bucket list? (Choose all that apply.) *

Q.5
Do you want to live to 100? *

Q.6
If you don’t want to live to 100, why not? *

Q.7
What was your oldest parent’s age at death (or current age if still living)? *

Q.8
Based on your family history, what's your biggest health concern? *

Q.9
How much do you believe genetics determine how long you will live? *

Q.10
Which of the following have you used to determine your inherited health risks? (Choose all that apply.) *

Q.11
What do you think is the most promising medical innovation that will help us all live longer and healthier? *

Q.12
Do you think happiness affects length of life? *

Q.13
What’s the biggest source of stress in your life? *

Q.14
How do you best manage your stress? (Choose all that apply.) *

Q.15
Have you noticed any signs of memory loss or recall issues? *

Q.16
What steps have you taken to protect your memory? (Choose all that apply.) *

Q.17
If you don’t get enough sleep, what’s the primary reason? *

Q.18
Are you a caregiver for a parent, spouse or other adult? *

Q.19
If you’re a caregiver, what’s one of the biggest challenges? *

Q.20
At what age do you plan to retire? (If you have already retired, indicate the age of your retirement.) *

Q.21
How do you plan to spend/are you spending your retirement years? (Choose all that apply.) *

Q.22
Do you plan to make/have you made any of these major changes with retirement? (Choose all that apply.) *

Q.23
If you live a long healthy life, where do you think you’ll be living in the last five years? *

Q.24
On a scale of 1–5, with 1 being not confident at all and 5 being very confident, how confident do you feel that you have enough money/financial knowledge to live to 100? *

Q.25
What would make you happier in your golden years? (Choose all that apply.) *

Q.26
Which screenings do you get on a regular basis to maintain your health? (Choose all that apply.) *

Q.27
What, if any, changes to your diet have you made as you have aged? (Choose all that apply.) *

Q.28
Do you have a “health buddy” and/or “financial buddy” in your life who helps keep you accountable? *

Q.29
What strategies would you consider to stay healthy as you age? (Choose all that apply.) *

Q.30
What is your age? *

Q.31
Please enter your address. *



Q.32
Please enter your name. (Mandatory if you’d like to be included in a drawing for a $500 Amazon gift card)


Q.33
Please enter your email address. (Mandatory if you’d like to be included in a drawing for a $500 Amazon gift card)

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