Women's Bodies, Women's Wisdom (131 page)

Family History

For each family member, note age (if still living), any important diseases (alcoholism, high blood pressure, cancer, diabetes, heart disease, osteoporosis, other addictions, other illnesses), and cause of death and age at death (if applicable).

Daily Living Profile

Indicate whether each statement does or does not describe part of your current life by circling “yes” or “no.” This questionnaire is designed to increase your awareness of the effects of your lifestyle and stresses on your physical well- being. It is based on the one I used at Women to Women for years.