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Professional Evaluation Medical Group Health Quiz

\Print out the form below and circle the answer that best describes you. When finished, add up the points for all your answer's. Compare your total to the risk table at the end of the quiz. Remember, knowledge is the first step in healthcare.
This short quiz will give you an indication as to the importance of the periodic preventive physical examination.

PEMG Health Quiz

1. Do you have high blood pressure?
Yes No Don't Know
20 points 0 points 20 points

2. Do you exercise (walk, bike, run, dance) 3 or 4 times a week?
Yes No
0 points 20 points

3. Is your weight:
     The ideal weight for your height or slightly below
            0 points
     15 or more pounds over ideal weight
            20 points

4. Are you aware of your family history (heart disease, diabetes, etc.)?
Yes No Don't Know
0 points 20 points 20 points

5. Do you have high cholesterol?
Yes No Don't Know
20 points 0 points 20 points

6. Do you have stress in your life?
     Seldom and I cope very well
            0 points
     Very stressed and I frequently have trouble coping
            20 points

7. When was the last time you had a health examination?
1 year ago 2 or more years ago
2 points 10 points

To determine your score, add up the points for each answer.
Your total:

How to score
30 Points or Less - Keep up the good work. Remember: no smoking, healthy diet, exercise, and regular physical examinations will help to keep you healthy
30 - 50 Points - You have several risk factors that should be discussed with your physician.
50 Points or Above - It is very important that you see your physician to learn more about your health and reduce your health risks.

380 South Broadway
Hicksville, NY 11801

Tel: (800) 811-PEMG
Tel: (516) 935-4378
Fax: (516) 931-3117

E-Mail - info@professionalevaluationgroup.com