3
Select your BMI group from the following choices:
On the left-hand side of the BMI chart below, circle your height; then, on the bottom of the chart circle your weight. Find where the two of them intersect (where your height crosses with your weight) and you have found your BMI score!
5
Do you usually do some physical activity such as brisk walking for at least 30 minutes each day?
This activity can be done while at work or at home
6
How often do you eat vegetables or fruits?
7
Have you ever be told by a doctor or nurse that you have high blood pressure? OR have you ever taken high blood pressure pills?
8
Have you ever been found to have high blood sugar either from a blood test, during an illness, or during pregnancy?
9
Have you ever given birth to a large baby weighing 9 pounds (4.1 kg) or more?
10
Have any of your blood relatives ever been diagnosed with diabetes? Check ALL that apply.
Some types of diabetes run in families.
11
Please check off which of the following ethnic groups your biological (blood) parents belong to:
Choose only one score, the highest.
For example: If you mom is black (score 5) and your dad is white (score 0) please click on Black.
12
What is the highest level of education that you have completed?
