We proudly serve families from Santa Barbara to Newport Beach | Connect with Lori | (818) 620-1442 |     

Balance Profile Quiz

To assess your potential risk for a fall, take my quick Balance Profile Quiz.Balance Profile Quiz

After completing the quiz, you will receive an email with your results and helpful balance tips.

Your information is confidential and will not be shared outside of the Lori Michiel Fitness organization.

If Yes, enter 5. If No, enter 0.
If Yes, enter 0. If No, enter 5.
If Yes, enter 0. If No, enter 5.
If Yes, enter 5. If No enter 0.
If Yes, enter 5. If No, enter 0.
If Yes, enter 0. If No, enter 5.
If Yes, enter 5. If No, enter 0.
If you are 45-64 enter 0 / If you are 65-79 enter 5 / If you are 80+ enter 10
To receive your results, please enter your Name and Email. Your information is secure and only being used for the purpose of this survey. We do not sell or share your information.
Name(Required)

 

Pin It on Pinterest