Have you ever been told by a health professional to have high blood pressure?

Have you ever been told by a health professional to have high blood cholesterol?

Have you checked your cholesterol level within the past five years

Body Mass Index (BMI)

Have you smoked at least 100 cigarettes in your entire life? Note:
5 packs is around 100 cigarettes

Have you ever had a stroke?

Do you have coronary heart disease (CHD) or myocardial infarction (MI)?

Have you done any physical activity or exercise during the past 30 days other than your regular job?

Do you consume fruit(s) 1 or more times per day?

Do you consume vegetable(s) 1 or more times per day?

Are you a heavy drinker? Men:
More than 14 drinks per week

Women:
More than 7 drinks per week

Do you have any kind of health care coverage? Includes:
health insurance, prepaid plans such as HMOs, or government plans such as Medicare, or Indian Health Service

Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?

How would you rate your general health

Now thinking about your mental health, for how many days during the past 30 days was your mental health not good? Includes:
stress, depression, and problems with emotions

Now thinking about your physical health, for how many days during the past 30 days was your physical health not good? Includes:
physical illness and injury

Do you have serious difficulty walking or climbing stairs?

Please indicate your sex

Please select your age category

What is the highest grade or year of school you completed?

Please input your annual household income bracket from all sources