Health Screening Recommendation Survey

The goal of this health questionnaire is to help you gain a better sense of where you stand with your preventative care. Print or email your completed assessment and share it with your doctor.

The questionnaire is based on the preventative guidelines provided by the U.S. Department of Health and Human Services Office on Women’s Health and the Centers for Disease Control and Prevention.

Information contained herein is not intended as a substitute for professional medical advice. If you have medical concerns, seek the guidance of a healthcare professional.

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By completing the health questionnaire you agree to the privacy and terms.