Obesity Quiz – Klinik Hello Doctor

1. Obesity and Non-Communicable Diseases

What is your current weight and height?

Weight (kg)

Height (cm)

Do you have a history of any of the following conditions?

Select all that apply

Heart disease

Type 2 diabetes

Stroke

High cholesterol

Hypertension

Others

No medical illness

Others

Are you currently taking any medications?

Yes

No

Medication details

Have you experienced any of these symptoms recently?

Select all that apply

Shortness of breath during light activities

Swelling in your legs or feet

Increased thirst or frequent urination

Fatigue or feeling tired most of the time

Difficulty sleeping

How would you describe your diet and activity level?

Balanced and Active

Moderate

Unhealthy and Inactive

First Name

Last Name

Email

Phone/Mobile

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