Health Risk Analysis (HRA)

The idea and motivation behind making this form was to catch a disease before it catches you. By the time symptoms appear, correction becomes harder.

Our structured Health Risk Assessment identifies risk patterns early hence allowing preventive intervention before complications escalate.

This is not a generic questionnaire. It is a guided review designed to evaluate your current health stability and future risk trajectory.

Take the assessment, Answer the Questions with all honesty. Understand your position. Act with clarity, the Healthness+ way.

Healthness+ Health Risk Assessment (HRA)

Personal & Lifestyle Overview
Nutrition & Eating Patterns
Digestive & Gut Health
Metabolic & Cardiovascular Health
Lifestyle, Sleep & Stress Load
Symptoms, Energy & Quality of Life

Name

How do you identify your gender?

Male

Female

Phone/Mobile

What Is Your Age?

Your Current Weight in KG

Height in Feet Only (If You are 5 Feet 10 Inches then please write Only 5 Here)

Height in Inches Only (If You are 5 Feet 10 Inches, then only write 10 Here)

Your Calculated BMI

How many days per week do you engage in intentional physical activity (brisk walking, gym, yoga, sports, etc.) for at least 30 minutes?

5 or more days per week

3–4 days per week

1–2 days per week

Rarely or none

How frequently do you consume processed, packaged, or fast foods (including ready-to-eat snacks, fried foods, bakery items, sugary beverages)?

Rarely or less than once per week

2 to 3 Times Weekly

Almost Daily

Multiple Times In A Day

How consistent are your meal timings on most days?

Meals at consistent times daily

Minor variation but mostly consistent

Frequently delayed or skipped meals

Highly irregular or unpredictable meal pattern

How often do you consume foods or beverages high in added sugar (desserts, sweets, sweetened drinks, bakery items)?

Rarely

Few Times A Week

Almost Daily

Multiple Times A Day

On average, how many servings of fruits and vegetables do you consume per day? (1 serving ≈ 1 cup raw vegetables or 1 medium fruit)

5 Or More Servings

3 To 4 Servings

1 To 2 Servings

Rarely Or None

How much plain water do you consume daily (excluding tea/coffee/sweetened beverages)?

2.5 + Litres

1.5 - 2 Litres

Less Than 1.5 Litres

Very Minimal Intake

Lifestyle & Nutrition Section Total

How often do you experience bloating, gas, abdominal discomfort, or heaviness after meals?

Never

Occasionally (1–2 times per week)

Frequently (3–5 times per week)

Almost Daily

How would you describe your bowel movements?

Daily & Comfortable

Mostly regular with occasional variation

Often Irregular (skipped days or urgency)

Frequently constipated, loose, or dependent on aids

Do certain foods consistently cause digestive discomfort or unusual symptoms?

Occasionally

Yes, multiple foods trigger discomfort

Yes, frequent discomfort but triggers unclear

Do you have any food allergies?

Not Known

Yes - Multiple Foods

Yes - Unsure which Foods

Do you regularly use antacids, laxatives, or digestive aids?

Occasionally

Frequently

Daily

Digestive Health & Gut Health Section Total

Over the past 12 months, your body weight has:

Remained stable (±2 kg)

Increased slightly (2–5 kg)

Increased significantly (>5 kg)

Fluctuated frequently (gain and loss cycles)

Have you ever been told you have high blood sugar or pre-diabetes?

Borderline once, not persistent

Diagnosed as pre-diabetic

Diagnosed diabetic

Have you ever been diagnosed with high blood pressure?

Occasionally Elevated Readings

Previously high, Improved With Lifestyle

On Medication for BP

Have you had abnormal cholesterol or lipid levels?

Borderline Levels

Previously high, improved with lifestyle

On medication for cholesterol

Do you have a family history of diabetes, heart disease, or stroke?

One Parent

Multiple Family Members

Early Onset (<55 Years of Age)

Metabolic & Cardiovascular Health Section Total

On most days, how many hours of sleep do you get?

7-8 Hours

6-7 Hours

5-6 Hours

Less Than 5 Hours

How would you describe your sleep quality?

Restful & Uninterrupted

Occasionally Disturbed

Frequently Disturbed

Poor & Non-Restorative

How would you rate your daily stress levels?

Low & Manageable

Moderate

High

Constantly Overwhelming

What best describes your daily movement pattern?

Structured exercise + active lifestyle

Light Activity (Walking, Yoga)

Mostly sedentary workday

Sedentary Lifestyle

Do you feel you have adequate time for mental and physical recovery?

Yes, Consistently

Sometimes

Rarely

Almost Never

Lifestyle, Sleep & Stress Load Section Total

How are your energy levels through the day?

Consistent and sustained energy

Mild dips but manageable

Frequent fatigue or afternoon crashes

Exhausted most of the day

How often do digestive symptoms affect your comfort (bloating, acidity, constipation)?

Rarely Or Never

Occasionally

Frequently

Almost Daily

Do you experience body pain, stiffness, or inflammation?

Occasionally

Frequently

Almost Daily

How would you rate your mental clarity and focus?

Sharp & Focused

Occasionally Foggy

Frequently Foggy

Poor Concentration Most of the Days

Overall, how would you rate your current health?

Excellent

Good

Fair

Poor

Symptoms, Energy & Quality Of Life Section Total

Total Score

Please tick the box before submitting

Text Input

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Healthness+ offers a science-backed online health risk assessment India residents can complete from anywhere. Our preventive health consultation online model combines clinical insight with personalized lifestyle guidance. Based in Bangalore, we also provide specialized health risk assessment Bangalore consultations for individuals seeking structured preventive care.