Family History

Please answer yes or no to the following questions regarding your family history.


Heart attack yes no
High blood pressure yes no
High cholestrol yes no
Stroke yes no
Cardiovascular Disease yes no

Personal History

Please answer yes or no to the following questions regarding your own health history.


Heart Attack yes no
Heart Surgery yes no
High Blood Pressure yes no
Chest Pain yes no
High Cholestrol
(Over 240)
yes no
Inactivity for more than1 Year yes no
Stroke yes no
Cardiovascular Disease yes no
High Stress Level yes no
Diabetes yes no
Nicotine Habit yes no

Joint Pain

Please answer yes or no to the following questions regarding your own health history.


Do you experience pain in your knee while walking or using stairs? yes no
Do you experience pain in your hip while walking or using stairs? yes no
Do you experience pain in your ankle while walking or using stairs? yes no

RESULTS