myuhc.com > Health & Wellness Home
 
  Home  |  Conditions AtoZ  |  Tools  |  Lifestyles  |  Drug Guide  |  Encyclopedia My Topics | Online Health Coach | Personal Health Record    
     
    CHRIS JOHNSON      
    Profile | Log Out You have 7 new messages! You have 0 Health Dollar(s)  
   
Personal Health Record
   
  Download Printer-Friendly Help


Social History
 
 Do you drink (alcohol)?
Yes No

 If yes, how many drinks per day?

 Are you currently or in the past had been under treatment to help you stop  drinking?

Yes No

 Do you smoke?

Yes No

 If yes, do you smoke more than a pack a day?
Yes No

 Are you currently or in the past had been under treatment to help you to stop  smoking?

Yes No

 Are you currently or in the past had been under treatment for medication  abuse, drug abuse or alcohol abuse?

Yes No

 
 
 
 
 
 
 
 
 
 
 
 
 
Diabetes
Hypertension
Conjunctivitis
Hepatitis
 
 
 
  Health & Wellness Technical Support: 866-868-5484  
  Terms and Conditions | Privacy & Security | About This Site Mon, Feb 12, 2007              ©HealthAtoZ 2006