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Cardiac Risk Assessment Form

The document is a cardiac risk screening form used by a local council. It includes sections for personal information, medical history, and various health metrics such as cholesterol, diabetes, smoking status, blood pressure, weight, height, and BMI. The form is designed to assess an individual's cardiovascular risk factors.

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aizadoll12
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32 views1 page

Cardiac Risk Assessment Form

The document is a cardiac risk screening form used by a local council. It includes sections for personal information, medical history, and various health metrics such as cholesterol, diabetes, smoking status, blood pressure, weight, height, and BMI. The form is designed to assess an individual's cardiovascular risk factors.

Uploaded by

aizadoll12
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Cardiac Risk Screening

Local Council JK Date

( )Tick Pervious History of

Cholesterol
DIABETES

Smoking
GENDER

Diseases
pressure

Smoking

Current
(Sugar)

Weight
BP BMI=

Kidney

Height
Sr

Stroke

(KG)
Blood

(CM)
CNIC NUMBER

AGE
FULL NAME READIN Weight
no Contact Number
G (Height)2

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