Question 1/10

Do you have a family history of heart disease?

Yes
No

Question 2/10

Have you been diagnosed with high blood pressure or high cholesterol?

Yes
No

Question 3/10

How often do you experience chest pain or discomfort?

Rarely
Occasionally
Frequently
Never

Question 4/10

Are you aware of your blood pressure levels?

Yes, I check regularly
Occasionally
No, I don’t monitor it

Question 5/10

How often do you exercise per week?

Never
1–2 times
3–5 times
Daily

Question 6/10

Do you smoke or use tobacco products?

Yes
No

Question 7/10

How would you describe your diet?

Healthy/Balanced
High-fat

Question 8/10

Do you experience shortness of breath during activities?

Yes
No

Question 9/10

Have you had any heart-related tests in the past years?

Yes
No

Question 10/10

Do you currently take heart-related medications?

Yes
No