Health Assessment Quiz – Crux Pharmacy

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WELLNESS SNAPSHOT • PHARMACIST GUIDANCE • HEALTH CLUB

Crux Health Assessment

Let's learn a little about your health.

Answer a few questions and receive a personalized wellness snapshot, practical recommendations, and guidance from the Crux team.

Your Health Goals

What would you most like to improve right now?

Choose up to 3.

Energy Weight Sleep Blood Pressure Blood Sugar Cholesterol Stress Digestion Skin Immunity General Wellness

About You

Age GroupGenderOccupation

Your Current Health

Have you ever been diagnosed with any of the following?

Select all that apply.

High Blood Pressure Diabetes High Cholesterol Asthma Arthritis Heart Disease None

Do you currently take any medications regularly?

Yes No

Which medications?

Lifestyle

How often do you exercise?

Daily 3–5 times weekly Once weekly Rarely Never

How would you describe your eating habits?

Excellent Good Fair Poor

How would you rate your sleep?

Excellent Good Fair Poor

How stressed do you feel most weeks?

Low Moderate High Very High

Weight & Body

How do you currently feel about your weight?

Happy with it Would like to lose a little Would like to lose significant weight Would like to gain weight

Have you tried to change your weight before?

Successfully Started but stopped Lost weight but regained it Never tried

Health Monitoring

Do you know your blood pressure?

Yes No

Do you know your blood sugar?

Yes No

Have you checked your cholesterol within the last year?

Yes No

When last did you have a general health check?

Within 6 months Within 1 year More than 1 year Can't remember

Readiness

How ready are you to improve your health?

7/10

1 means not ready yet. 10 means very ready.

Join Crux Health Club Free

Where should we send your personalized health report?

Full NamePhone / WhatsAppEmail

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