Heart Health Assessment Find out if you are at risk for heart disease Indicates required field First Name Last Name Email Gender Are you a smoker or were you for a significant portion of your life? Yes No Do you have diabetes? Yes, Type 1 Yes, Type 2 No Do you have a family history of heart issues? Yes No Do you have a history of high blood pressure? Yes No Have you ever been diagnosed or treated for high cholesterol? Yes No Are you over 64? Yes No Send me educational information? Yes No Math question 3 + 16 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.