Danbar Healthcare Analytics, LLC
"Health Analytics and Automated Virtual Educational Support"
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Health Risk Assessment
Let's Build You a Custom Program
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These questions will allow us to build your custom lifestyle program.
1) What is your height?
3
4
5
6
7
feet
1
2
3
4
5
6
7
8
9
10
11
inches
2) What is your weight?
lbs.
3) Which age range, in years, are you in?
18 - 25
26 - 35
36 - 45
46 - 55
56 - 65
66+
4) What is your gender?
female
male
5) What is your waistline at the hips?
inches
6) Do you have any of the following medically diagnosed chronic health conditions, including diabetes mellitus, high blood pressure, cardiovascular disease or heart problem?
no
yes
7) Has your doctor started you on any medication to treat any of these or related conditions?
no
yes
8) What is your daily activity level?
Inactive or sedentary [do not get any regular exercise]
Minimally active [exercise less than 30 minutes per week]
Mildly active [exercise 30 to 60 minutes per week]
Moderately active [exercise 60 to 90 minutes or more per week]
9) Do you feel confident with your understanding of your health risk factors, BMI and weight classification when discussing it with your health provider, family and/or friends?
no
yes
10) Are you satisfied & comfortable with current weight and BMI as it relates to your health status and current weight goal?
no
yes
11) Are you at-risk for complications related to being overweight or obesity?
no
yes
12) Are you contemplating bariatric or weight loss surgery within the next year or so?
no
yes
13) Would you like to learn more about how to successfully start and implement a healthy lifestyle change-management program for health improvement and long-term weight control?
no
yes
14) Do you currently take multivitamins, vitamin D3, or other immune-enhancement supplements?
no
yes
15) Would you like to have a personal coach or take the lifestyle change process on by yourself?
with a personal coach
on my own
