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# 1 Wellness Profile
Allergies
Anemia
Cancer-Safe-Male
Cancer-safe-Female
Cardiovascular
Diabetes
Gastro-Intestinal
Hormone Panel-Female
Hormone Panel-Male
Men's Health
Women's Health
STD
Thyroid
Heart
Diabetes
BMI - Obesity
Health Risk Calculators: Heart
About you
Age
yrs
Waist size
inches
Gender:
Male
Female
General Information -- Select those that apply
Do immediate family* have diabetes?
*mother, father, brothers or sisters
Yes
No
Fish ≥ 2 servings per week
Yes
No
Fruit/Vegetables ≥ 5 servings per day
Yes
No
Nuts ≥ 3 servings per week
Yes
No
Saturated fat ≥ 2 servings per day
Yes
No
Trans fats ≥ 4 servings per week
Yes
No
Mono & polyunsaturated fat ≥ 4 servings per week
Yes
No
Multivitamin/B complex supplement
Yes
No
Physical activity at least 30 minutes per day or 3 hours per week
Yes
No
Cereal fiber/Whole grain ≥ 3 serving per day
Yes
No
Alcohol intake ≥ 1 serving per day
Yes
No
Smoke cigarettes per day
None
1-14
15-25
>25
Quit smoking for < 10 yrs
Passive smoke, regularly exposed
Clinical Information -- Select those that apply
Do you have diabetes?
Yes
No
Do you suffer from Hypertension (high blood pressure)
Yes
No
Do you have high cholesterol
Yes
No
HDL cholesterol < 40 (mg/dL)
Yes
No
Total cholesterol Range (mg/dL)
Less than 160
160-199
200-239
240-279
Greater than or equal to 280
If unknown
Click here to calculate BMI
Body mass index
Your answers indicate that your heart is probably not at risk.*
The answers indicate that you may be at mild risk for Heart Disease. Your doctor can help you make the appropriate decisions about receiving testing for diagnostic confirmation. We recommend ordering the
Complete Wellness Profile
in testing for detection of Cardiovascular Disease.*
The answers indicate that you may be at moderate risk for Heart Disease. Your doctor can help you make the appropriate decisions about receiving testing for diagnostic confirmation. We recommend ordering the
Complete Wellness Profile
in testing for detection of Cardiovascular Disease.*
The answers indicate that you may be at high risk for Heart Disease. Your doctor can help you make the appropriate decisions about receiving testing for diagnostic confirmation. We recommend ordering the
Complete Wellness Profile
in testing for detection of Cardiovascular Disease.*
Note: *The results you receive from this tool are for informational purposes only and should not be the basis of your medical decision making. Consult your physician to determine the medical implications of any tests you take.
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