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My Health and Medical History

The health and medical history information you provide in these questionnaires plays vital roles in the interpretation of your health checks and blood test results.

Health goals and interests

Please tick all that apply

Weight loss Diet and lifestyle Healthy heart Diabetes Hormones Thyroid health Sporting performance Energy Tracking and optimizing General health

Medical History

Do you suffer from or have you ever been diagnosed with any of the following conditions?

High Blood Pressure

No Yes

High cholesterol

No Yes

High blood glucose or diabetes

No Yes

Heart attack or stroke

No Yes

Atrial fibrillation

No Yes

Thyroid disorder

No Yes

Liver disease

No Yes

Fertility problems

No Yes

Bowel condition

No Yes

Kidney problem

No Yes

Inflammatory conditions

No Yes

Migraines

No Yes

Mental health issues

No Yes

Is there anything else you would like to tell us about your medical history?

Family History

Tell us about any 1st degree (parent or sibling) family medical history

Heart attack or angina

No Yes

Type 2 diabetes

No Yes

Clotting disorder(thrombosis)

No Yes

Autoimmune disease

No Yes

Cancer

No Yes

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My Health and Medical History

Do you suffer from or have you ever been diagnosed with any of the following conditions?

Tell us about any 1st degree (parent or sibling) family medical history

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Information

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