Participant+Survey

Thank you for taking this step toward better heart health. Please fill out the survey below. Your fictitious name is on the survey. Please use this name in all of your blog posts to keep your identity confidential. Name: Joe Shmoe Gender: Male Blood Pressure at time of visit: __Weight:__ __Height: Resting heart rate: Target heart rate: Resting heart rate return rate:__ Do you smoke cigarettes? Do you drink alcohol? Yes / No If yes, on average how much per week?
 * __ Healthy Heart Participant Heart Health Survey  __**

Do you exercise? Yes / No If yes, on average how much per week?

Do you have any family history of heart disease?

Have you ever been treated for heart-related issues? Yes / No If yes, please briefly explain.

What, if any, health goals do you have?

Thank you for filling out the survey. Please remember to blog about your daily eating, exercise and other health related habits for the first week of the project.