University of Michigan Health Management Research Center

Health Risk Appraisal Questionnaire
HMRC Version

Before beginning this questionnaire, please have your medical information at hand, including your height, weight, approximate dates of most recent preventive services and health screenings, and blood pressure and cholesterol measurements, if known. While none of this information is required, including it will make your HRA Profile more accurate and complete.

You may submit a questionnaire as frequently as every six months. You may return here to see your current report whenever you wish.

Your privacy comes first! Your Last Name and Identification Number are required to confirm your eligibility to take advantage of this Health Risk Appraisal (HRA). Beyond this purpose, your information is considered anonymous. Your data are held in confidence by the University of Michigan Health Management Research Center and are used in an aggregate, anonymous form for reporting and scientific research. The University of Michigan Health Management Research Center may be informed of your participation in this HRA for incentive or other purposes. For complete details, see our privacy statement via the "Privacy" link above.

Last Name Identification Number
HRA Password
For the privacy of your information,
a. If this is your first time here, please enter any password of your choice, using at least four letters or digits. Record and save this password to use when you return here other times. Enter your chosen password twice, once in each box.
b. If you've already registered a password, please enter it once here. This password is not required to enter to complete a questionnaire. However, without it, for the privacy of your information, your report will not include any comparison results from your previous questionnaire.

I've lost my password

To personalize your questionnaire:

Cigarette Smoking
How would you describe your cigarette smoking habits?
Still smoke cigarettes
Used to smoke cigarettes
Never smoked cigarettes

The Health Risk Appraisal is not a substitute for a medical exam. If you have health concerns or if the report raises questions, please consult your physician or a health professional to review the results with you.

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Apr 18, 2014; 2:17:14 EDT Problems: