Annual Review Chronic Disease Questionnaire

Annual Review Chronic Disease Questionnaire
Health and Lifestyle

Measuring your waist is a good way to check you're not carrying too much fat around your stomach, which can raise your risk of heart disease, type 2 diabetes, cancer and stroke. You can have a healthy BMI and still have too much tummy fat. To measure your waist:

• find the bottom of your ribs and the top of your hips

• wrap a tape measure around your waist, midway between these points

• breathe out naturally before taking the measurement

Exercise: Physical Activity Questionnaire

During the last week, how many hours did you spend on each of the following activities?

Blood Pressure

Home Blood Pressure targets

• Under 80 years old <135/85

• Over 80 years old < 145/85

• Type 1 diabetes < 130/80; Type 2 diabetes < 135/75

• Or as agreed with your doctor or nurse

Many people with Long Term Conditions suffer from undiagnosed depression.
Increased breathlessness can often be a sign of poor health.
Smoking and Alcohol

The number of units in a drink is based on the size of the drink, as well as its alcohol strength. To keep health risks from alcohol to a low level. PLEASE FOLLOW THE ADVICE BELOW:

If you drink most weeks - men and women are advised not to drink more than 14 units a week on a regular basis. If you regularly drink as much as 14 units a week spread your drinking over 3 or more days, and if you want to cut down, try to have several drink-free days each week.

Fourteen units is equivalent to 6 pints of average-strength beer or 10 small glasses of low-strength wine.

Depending on your answers you may be asked to complete an additional alcohol questionnaire.

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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