Male
Female
High blood pressure (hypertension)
High blood cholesterol
Diabetes or a problem with blood sugar
Heart Disease/Had a Heart Attack
Stroke
Cancer - Any type other than basal or squamous cell skin cancer
Liver Diesease
Chronic kidney diesease/Udergoing Dialysis
Immune Deficiency
None
Heart Disease
Diabetes
Breast and / or Ovarian Cancer
Cervical Cancer
Colorectal Cancer
Lung Cancer
Uterine Cancer
Prostrate Cancer
Stomach Cancer
Yes
No
No - I Never Smoked
I have Quit Smoking
No - I Never Drank alcohol
No - I have Quit Drinking Alcohol
Less than 1 hour
1 hour
2 hour
3 hour
4 hour
More than 5 hours
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