Health Check Quiz

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Date: Sunday 6th November 2011
Place: Petone Foreshore
Date: Thursday 17th November 2011
Place: Two Mile Bay Boat Ramp, Lake Taupo

Health Check Quiz

Please take a moment to complete this quiz.

I prefer to respond anonymously:

No Yes

Name

Do you smoke?

YES No Don't Know

Do you have more than 3 alcoholic drinks a day?

YES No Don't Know

Do you come from a Maori/Pacific Island or Indian family?

YES No Don't Know

Do you have high blood pressure?

YES No Don't Know

Do you have high cholesterol?

YES No Don't Know

Do you have diabetes?

YES No Don't Know

Do you have close family members with cardiovascular disease, cancer or diabetes?

YES No Don't Know

Are you overweight?

Your waist measurement:

- for WOMEN: more that 90cm
-for MEN: more than 100cm

YES No Don't Know

Do you eat high fat food (such as fried foods, gravies, butter, eggs, cream) most days?

YES No Don't Know

Do you exercise for less than 30-minutes 3 times a week?

YES No Don't Know

Is it 2 years or more since you have seen your doctor for a general health check?

YES No Don't Know