Velocity Health

Health Risk Assessment

Live a Healthier and Happier Longer Life

Get access to Velocity Wellness Programs that cover 8 facets of employee wellness in these areas - Occupational, Physical, Emotional, Financial, Social, Environmental, Intellectual and Spiritual Wellness.

Building One, Prism Business Park, Ruby Close,

Fourways, Johannesburg, South Africa

011 568 0600

40 Lawley Avenue Belvedere,

Harare, Zimbabwe

+263 242 711 402

Member`s Details

Demography

First Name

Surname

Phone

Gender

Male

Female

Behavior

In general, how would you rate your health?

Excellent

Very Good

Good

Fair

Poor

In the past 7 days, how often did you exercise for at least 20 minutes in a day?

Every day

3-6 days

1-2 days

0 days

In the past 7 days, how often did you eat 3 or more servings of fruits or vegetables in a day?

Every day

3-6 days

1-2 days

0 days

In the past 7 days, how often did you have (5 or more for men, 4 or more for women) alcoholic drinks at one time?

Never

Once a week

2-3 times a week

More than 3 times during the week

In the past 30 days have you smoked or used tobacco?

Yes

Do you want to quit smoking or using tobacco?

Yes

I am working on quitting or cutting back right now

Medical

In the past 30 days, how often have you felt tense, anxious or depressed?

Almost every day

Sometimes

Rarely

Never

Do you use drugs or medications (other than exactly as prescribed for you) which affect your mood or help you to relax?

Almost every day

Sometimes

Rarely

Never

A checkup is a visit to a doctor’s office that is NOT for a specific problem. How long has it been since your last checkup?

Less than a year

Between 1-3 years

More than 3 years

State whether or not you have suffered from the following

High BP

Yes

Diabetes

Yes

Any family member who has been diagnosed with a chronic condition?

High BP

Yes

Diabetes

Yes