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1. Please rate how concerned you are about each of the following:

5 pt. Scale: 5=Extremly concerned, 4=Very concerned, 3=Somewhat concerned, 2=Not very concerned, 1=Not at all concerned.

 
Cholesterol
5 4 3 2 1
 
Diabetes
5 4 3 2 1
 
Osteoporosis
5 4 3 2 1
 
Heart/Cardiovascular Health
5 4 3 2 1
 
High Blood Pressure
5 4 3 2 1
   
   
2. Please select the statement that best matches how you feel about your heart health (cholesterol, high blood pressure or heart/cardioivasculer health):
Improving my heart health is a top priority and I'm doing whatever I can to reach my goals.
I've tried almost everything to improve my heart health and nothing seems to work for me.
I'm trying to improve my heart health, so I've made some changes in my diet to eat healthier.
I know that I should be more careful about watching my heart health, but I'm having a difficult time sticking with a heart healthy diet all the time.
I'm not concerned at all about my heart health.
   
   
3. Please indicate whether you are a Health Care Practitioner.
Yes, I am a Health Care practitioner.
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