Dickson Health Risk Assessment
The following questions will help determine if you are at risk for health issues. Inflammation is the underlying cause of all disease and these symptoms may indicate inflammation in your body. The answers will help you identify potential threats to your health and areas you may need to work on to prevent chronic pain and disease. Please be as honest as possible with your answers and tell us what we “need” to hear and not necessarily what we “want” to hear.
How do you measure up?.......Know your risk!
Do you have a family history of early cardiovascular disease (heart attack, bypass, transplant or stroke (a male relative affected before age 55+ or a female relative affected before age 65)?
No, but I do have a family member with later onset heart disease
Yes, on one side of the family
Yes on both sides of the family
Yes, and it is present in multiple generations
Do you have bleeding gums or gum disease? (Check all answers that apply)
I usually don’t floss but my gums never bleed or hurt
I usually don’t floss my teeth but my gums are sensitive:
Yes, when I brush or floss
My gums bleed without even having to floss my teeth
Which of the following best describes your sleep patterns?
I sleep soundly 7-8 hours a night
I sleep but restlessly for 6-8 hours a night
I sleep less than 7 hours or more than 9
I sleep less than 5 hours of poor quality sleep per night
I sleep less than 4 hours a night
Do you snore?
Yes, frequently and loudly
Yes, and I have sleep apnea
Yes and I have sleep apnea and so does at least one family member
Do you have rheumatoid arthritis, Celiac’s disease, a thyroid condition, psoriasis, lupus or any other inflammatory/autoimmune disease?
Yes, but it is controlled by medication
Yes, even though I am taking medication I still have consistent symptoms
Yes and symptoms are consistent and debilitating with or without medication
Yes and so does at least one family member
Have you been checked for vitamin D deficiency?
My vitamin D level is between 60-80
My vitamin D level is between 40-60
My vitamin D level is between 30-40
My vitamin D level is lower than 30
I do not know my vitamin D level
Do you have a history of migraine headaches?
Occasionally, but with no migraine aura
Yes on a regular basis, with no migraine aura
Yes on a regular basis, with a migraine aura
My headaches are debilitating, are all consuming and I have lost the ability to function
How would you characterize your ability to cope with stress?
I’m usually pretty laid back
I have stress but I have healthy ways to cope with stress
Sometimes people say that I seem stressed
I feel stressed and anxious most of the time
I feel stress all of the time and it is interfering with my life and my relationships
How much TOTAL time do you spend sitting (job, driving, home, TV, computer etc.)?
Less than 5 hours
Less than 7 hours
More than 9 hours
More than11 hours
More than 13 hours
How much formal exercise (cardio, mobility and strength training) do you get?
At least 30 minutes, 5 to 7 days per week
At least 30 minutes 2 to 4 times per week
At least 30 minutes 1 to 2 times per week
30 minutes, once a week or less
I do not exercise
Do you smoke or use tobacco products?
I used to smoke, but have quit for at least 5 years
I used to smoke, but quit less than 5 years ago
I am exposed to second hand smoke regularly
I smoke/use smokeless tobacco products infrequently (1-3 times per day)
Do you drink regular or diet soft drinks?
Rarely drink soda (diet or regular)
Once a week (diet or regular)
2-3 per week
Once or more a day
(Women only): Did you experience high blood pressure or gestational diabetes during pregnancy?
(Men only): Do have erectile dysfunction?
Do you take supplements daily that were recommended or prescribed by your health care provider?
Yes, every day
Yes, but only 5 days per week
Yes, when I remember
Not that were recommended by a health care provider but I do take supplements
No, I don’t take any supplements
Do you have diabetes or high blood sugar?
No but I have a family member that does
Yes, I’m pre-diabetic and or insulin resistant
Yes, I’m diabetic
I haven’t had my blood sugar tested
Do you have pain of any kind?
Yes, 1-2 times per month
Yes, 1-2 times per week
Yes, more than 1-2 times per week
Yes, every day and constant
Do you have healthy relationships and a rich social network of friends and activities?
Absolutely, totally agree
I wouldn’t call it “rich” but I have friends and see them from time to time
I really don’t have a lot of friends and see them occasionally
I don’t have any friends and I really like it that way
Do you drink alcohol?
Yes, 1-2 glasses 3x or less per week (3-6 glasses total)
Yes, 1-2 glasses 7x per week (7-13 glasses total)
Yes, more than 2 glasses 7x per week (14+ glasses total)
Yes, every day and more than 3 drinks in a day
Do you eat meals or snacks that contain sugar in any form like cookies, cakes, candy, pastas, sugar-laden sauces such as ketchup, breads, etc.?
Yes, monthly 1-4 meals or snacks contain sugar
Yes, weekly 2-3 meals or snacks contain sugar
Yes, daily 2-3 meals or snacks contain sugar
Yes, daily 4+ meals or snacks contain sugar
Are you taking medication for chronic medical problems such as digestivedisorders; cardiovascular problems; high cholesterol; headaches; chronic pain; blood sugar problems; chronic fatigue; immune problems or chronic infections; or any other chronic conditions?
4 + medications
Submit to find out your health risk!
You have great health. Continue of your healthy lifestyle to
help you maintain your health.
You have some health risks, knowing your lab and
Wellness score will help direct you to improve your health and prevent
future chronic disease.
79 – 70
You have moderate risk for serious health problems, knowing your
Lab and wellness score will help you improve your health and you
need to make some serious lifestyle changes to regain your health.
69 – 60
You have a moderately high risk for cardiovascular disease, you need to
know the red flags for heart attack and stroke as well know your lab
and wellness score to make an immediate action plan to change your
lifestyle and protect your health
You have a high risk for cardiovascular disease, and other chronic inflammatory
Conditions. Do not delay in having your labs and wellness score done. These two
tests could save your life.
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