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Health Risk Profile

Personal Disease Screening Test Recommendations Disclaimer The Health Risk Profile (HRP) you are about to complete and the subsequent Disease Screening Test Recommendations which are about to be made to you as a result of your answers to the Health Risk Profile are based on general criteria collected from professional health organizations, medical doctors and non-profit organizations which specialize in specific diseases. Our Medical Director has provided us with a standing order prescribing the tests recommended for you as a result of your answers to the Health Risk Profile. While our Medical Director is licensed to practice medicine and is therefore qualified to make the recommendations provided herein, it is important for you to know that National Testing Service, Inc., AreYouPositive.com, ff2k.com and World Health Alliance are not qualified to and do not directly or indirectly practice medicine in any way.

The content and recommendations which are to follow are not intended in any way to be a substitute for professional medical advice, diagnosis or treatment. If you have questions regarding a specific medical condition please consult your physician or other qualified healthcare provider. Never delay seeking or disregard following professional medical advice because of something you have read here. Your acceptance below signifies that you agree to indemnify and hold National Testing Service, Inc., AreYouPositive.com, ff2k.com and World Health Alliance including, our officers, directors, employees, agents, licensors, shareholders and suppliers (indemnified parties) harmless from and against all claims, actions, liabilities, losses and damages arising out of, relating to, or in any way connected with actions you take or fail to take in connection with the Disease Screening Test Recommendations about be made to you based on your answers to the Health Risk Profile. Your acceptance further signifies that you agree the indemnified parties shall not be liable to you or anyone else for any loss or injury caused in whole or in part by our compiling, interpreting, reporting or delivering this information to you through any means, including this HTML Document.

This simple questionnaire will help you itemize your personal and family history risk factors, which considered together, help us to determine which screening tests you need for early identification of disease. Please answer the following questions, checking any boxes that apply, to receive your personalized Disease Screening Recommendations. It should only take a couple of minutes to complete the questionnaire and remember, accuracy and completeness of the information provided is critical.

1) Sex
Male Female

2) Age
yrs

3) Weight
pounds

4) Height
Feet Inches

5) Race

Black

Hispanic

Native American

Asian

Caucasian

Other

6) Smoking (all types)

Never

Previously

Currently

7) Alcohol beverages per day?

3 or more

8) How often do you exercise at least 20 minutes without stopping?

Less than once a week

Once or twice a week

Three times or more a week

9) How would you rate your energy level?

Low

Moderate

High

10) Do you have high blood pressure?

Yes

Don't know

11) Do you have high blood sugar levels?

Yes

Don't know

12) How would you rate your overall health

Excellent

Occasional illness

Poor

13) Do you have high cholesterol, HDL, LDL or Triglycerides

Yes

Don't know

14) Personal History
Blood transfusion
Frequent urination
Exposure to another person's blood
Unprotected sex with more than one
person by either partner
Work in a field where you have
contact with human bodily fluids

Chronic heartburn or acid reflux
Intravenous drug use
Frequent skin infections
Tick Bites
Shared toothbrush/razor
Blurred vision
Constant thirst or hunger

Any vascular disease including
blocked arteries
Numb or tingling extremities
Poor limb circulation
Slow healing wounds or sores
Any heart disease including heart
attack, angina or arrhythmia

15) Family History
Heart Disease
High Cholesterol
Lupus
Ovarian Cancer
Colon Cancer

Stroke
Diabetes
Osteoporosis
Liver Cancer
Pancreatic Cancer

High Blood Pressure
Epstein Barr
Prostate Cancer
Breast Cancer
Cancer of any kind

16) Bone Health
Loss of height greater than 1-1/2"
     from tallest remembered height
Currently have fractured bones
     present
Excessive caffeine (2+ cups of
     coffee or cans of caffeinated
     soda/day)

Thin, small build
Hyperparathyroidism
Chronic Hypercalciuria
Oral steroid use for 6 months or
longer

Osteomalacia
Chronic renal impairment
Inflammatory bowel disease
Lactase deficiency

17) Females Only
Currently pregnant
Currently taking estrogen
Early menopause (before age 45)
Had Hysterectomy

Currently Menstruating
Prolonged low estrogen
Currently entering menopause
or are post-menopausal

Interruption or cessation of
     menstrual periods due to
     anorexia, bulimia or excessive
     physical exercise

18) Males Only

Low testosterone

Hypogonadism


This program makes a Body Mass Index (BMI) calculation based on the height and weight information you provided earlier. Since BMI calculations only consider height and weight and not sex or body-frame size BMI calculations may not be appropriate for competitive athletes, bodybuilders or women who may be pregnant and/or lactating. According to "The American Journal of Clinical Nutrition" increased BMI is associated with increased health risks. As published there the upper limit of a healthy weight is defined as a BMI of 25, overweight as a BMI of 25-30, and obesity as a BMI of greater than 30. Since obesity is a known risk factor for heart disease, diabetes, high blood pressure, stroke, and some forms of cancer, weight management is critical for minimizing health risks. Your body mass index is and your height to weight ratio classifies you as .
PSA Test:
Ovarian Cancer Marker:
Heart Tests:
Diabetes Test:
H. Pylori Test:
Fatigue Test:
Hepatitis/C Test:
Osteoporosis Test:
"These recommendations are not intended to replace your personal healthcare provider or adviser."

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