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Diabetes Risk Assessment
Step 1
Step 2
Step 3
Step 4
Step 1: Personal Information
Age
Weight (kg)
Height (cm)
Next
Step 2: Health Factors
Family History of Diabetes
Yes
No
Do you engage in physical activity?
Yes
No
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Next
Step 3: Additional Factors
Do you smoke?
Yes
No
Do you have hypertension?
Yes
No
Do you have high cholesterol?
Yes
No
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Next
Final Step: Review and Submit
Please review your information before submitting.
Previous
Submit
