Free Health Risk Assessment

This questionnaire is a subjective assessment of stressors and related symptoms and complaints. The questions have assigned scores/point values.

• The process involves answering questions about your health and lifestyle.
• The form may take you between 10 minutes to complete.

Once you have completed answering all questions, Health eLifestyle will present to you the results along with relevant educational information to help you make informed decisions about your health.

• I understand that although Health eLifestyle staff includes Medical Doctors and Doctors of Chiropractic, they are NOT MY DOCTOR. In other words: interacting with this website and/or the self-evaluation form does not establish a doctor-patient relationship of any kind.
• Answering health question on the Health Risk Assessment Form does not and cannot imply a diagnosis of any kind. The suggestions found on this web site are based on typical symptom patterns that tend to occur with certain symptoms. This may or may not pertain to my specific circumstances.
• The products mentioned here and any recommended dosages are not intended to diagnose, treat, cure, or prevent any disease. No guarantees of any kind are or can be implied. I understand that when I provide answers to specific health questions and review the subsequent recommendations, any decisions I make are my own.
• The Health Risk Self Assessment Form cannot be used to monitor changes in health over time. It is intended to give initial, one time, feedback about typical symptom patterns that tend to occur.
• I agree to hold Health eLifestyle Program, the web page designers, and/or and any other listed supplement manufacturers harmless.
• I agree to be included on Health eLifestyle Program’s mailing list for information regarding cellular supplementation, lab testing, and relevant articles pertaining to my symptoms and/or health product updates. Health eLifestyle Program does not share this information with anyone outside our organization.
• I understand and I agree to the above terms.

Checking the "I agree" box below shall constitute an implicit acceptance of the foregoing terms herein set forth.