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Take a Survey

As MyDigitalHealth continues to evolve as new technology becomes accessible, we want to hear from you about your health concerns, health needs and how we can continue to be of maximum service to you.

We respect your privacy. Your responses will be kept confidential. Please see our Privacy Policy for details. You can also choose to submit this survey anonymously (without an email address).

Please take a few minutes to answer the following questions.

Do you get a medical physical and checkup annually? Yes No

If not, when was your last? Less than 2 years 2-5 years More than 5 years

What concerns about your health do you have? (Check all that apply) Diet Heart Disease Diabetes Aging Respiratory problems High Cholesterol High blood pressure
Family history of:
Heart Disease Diabetes Cancer Alzheimers

Have you taken a cholesterol test and do you have your numbers for LDL, HDL, total cholesterol, and triglycerides? Yes No

Have you taken a detailed lipoprotein profile cholesterol test, also known as a lipoprotein fractionation? Yes No I don't know

Would you be interested in getting a genetic analysis test if it could help you better understand your risks? Yes No

If not, check all that apply
I don't know what this is I don't believe in it I don't understand it My physician did not recommend it The cost is a barrier

Please check the items that apply to you: I belong to a health club I exercise at least three times a week I work with a personal trainer, currently I have worked with a personal trainer, but not currently I have taken a spa vacation I have visited a spa especially for its health and fitness program I feel that I have to lose weight. Check one:
5-10 pounds 10-20 pounds 20-40 pounds More than 40 pounds
I visit online health sites. Check all that apply:
WebMD^® RevolutionHealth™ Other
I am enrolled in a diet program. Check one:
Weight Watchers^® Jenny Craig^® Best Life^® Other / On my own
I am enrolled in a wellness program. Check all that apply:
Through my employer Through an online service Through my health plan

What are the most significant motivators for you to be healthy?
Be there for friends and family Be healthy Look better Improve fitness and performance Live longer/age well Manage/avoid chronic illness Other I am not motivated to be healthy

Would you be interested in using a service like MyDigitalHealth?
Yes No

Please comment:
What is your gender? Female Male

What is your age range? 18-35 36-54 55-74 75 and over

Where do you live?

State
Zip (if U.S. resident):
Country

Additional comments:

Thank you for taking the time to fill out this survey. Would you like to be kept up to date on MyDigitalHealth?

	Please submit my survey results anonymously.
	Please send me occasional updates about MyDigitalHealth; I have entered my email address below.
	E-Mail: I'm interested in becoming a beta user.