Cardiovascular Disease
Group Name One
Group Name One
Group Name One
Group Name One
Your Heart Age is
"x"
Years
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Group Title
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This question is not about gender identity, but rather physiological sex.
Female
Male
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What is your age?
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Here are some questions about your ability to live on your own
Have you had any difficulty with the following tasks in the past week?
X
Need help setting up for task
X
Need help setting up for task
X
Need help setting up for task
X
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
X
Need help setting up for task
X
Need help setting up for task
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
X
Need help setting up for task
X
Need help setting up for task
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
X
Need help setting up for task
X
Need help setting up for task
X
Need help setting up for task
Continue
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
X
Need help setting up for task
X
Need help setting up for task
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Have you had any difficulty with the following tasks in the past week?
Fruit Juice
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Fruit
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Potato
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Vegetable
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
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Have you had any difficulty with the following tasks in the past week?
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Group Title
Please indicate sex:
X
Need help setting up for task
X
Need help setting up for task
X
Need help setting up for task
X
Need help setting up for task
Continue
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Group Title
Weight
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Heigth
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Please indicate sex:
A
Checkbox Input
B
Checkbox Input
C
Checkbox Input
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Thank you! Your submission has been received!
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Calculate
Your Results
Your risk of having a
Heart Attack or Stroke
within the next 5 years is
X
%
In other words...
for 100 people with the same responses to you;
0
people will have a heart attack or stroke.
0
people will not have a heart attack or stroke.
End of Survey
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