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Please enter a valid date.
Example: 1 pack daily
Please include date and location
Have you EVER been diagnosed with, treated for, hospitalized for or been advised to seek treatment for:
Example: Diagnosed with elevated blood pressure 2 years ago – take 20 mg Lisinopril daily – last reading 128/82
Example: High Cholesterol – July 2014 – take Crestor 20mg / day – had physical in May – readings were great
Example: Nightly use of CPAP
Example: Brother, living, age 54, dx with heart disease at age 50
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