My Heart Survey

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What is your current age?(Required)

Under 40

40-54

55-70

70+

What is your gender?(Required)

Male

Female

Prefer not to say

Have you been diagnosed with any of these conditions? (Select all that apply)(Required)

Cardiovascular Disease (including heart attack or stroke)

Arthritis

Diabetes

Mental health disorders (depression, anxiety, etc.)

Obesity

Other ~ (Hormone imbalance, sleep apnea, etc.)

None

Have you had a cardiac event?(Required)

Heart attack

Stroke / aneurysm

Other

What would you describe as your biggest health challenge?(Required)

I’m having a hard time losing weight

It’s really difficult to change my eating habits

I’m having a hard time lowering my blood pressure and cholesterol numbers

I’m struggling to manage another health condition (diabetes, arthritis, sleep apnea, etc.)

None of the above

Are you focused on trying to manage your weight right now?(Required)

Yes

If so, what treatment options are you interested in exploring?(Required)

Medications

Behavior change program

Nutrition + exercise support

Bariatric surgery

None of the above

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Reaching a healthier weight can improve heart health.

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