This scorecard will help you determine your RiseVT score: a starting place for you to begin your journey to better health.
After submitting this, you will automatically receive your score out of 100 and be entered into our monthly drawing for a $50.00 Hannafords Gift Card!
How many fruits and vegetables do you eat each day: fresh, canned or frozen?
How much tobacco do you use each day (cigarettes, smokeless, cigars and even electronic-cigarettes)?
How much physical activity do you get each week?
On average, how much sleep do you get each night?
On average, how often to you socialize and spend quality time with important relationships in your life. This could be family, kids, friends, etc.
On average, how often do you spend each week having quiet time with no screens or distractions?
Do you eat a healthy breakfast each day?
How often do you have sugary sweetened beverages including soda, energy drinks, sports drinks, coffee drinks?
During the last 30 days I tried walking a path, trail or park in Franklin and Grand Isle, Vermont.
If yes, what walking a path, trail or park did you use?
Have you seen your primary care provider in the past year for an annual wellness visit?
The Special Supplemental Nutritional Program for Women, Infants, and Children (WIC) provides supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding post-partum women, and to infants and children up to age five. Would you like someone to contact you about WIC services?
We would love to help you rise to the challenge and improve your wellness. Please indicate which of the following you would like to learn more about and we will get in contact with you with the contact information you have given us.
Employer or School (if applicable)
How did you hear about RiseVT?