RISIKOFAKTOREN - Der Online-SChnelltest
1. Have you had a health check-up before?
yes no
2. Do you have a history of high blood pressure?
yes no
3. Have you ever had a metabolic disorder (e.g., high cholesterol / diabetes)?
yes no
4. Is there a tendency in your family towards heart attacks at an early age?
yes no
5. Do you smoke regularly?
yes no
6. Is there a high incidence of serious illness such as intestinal cancer in your family?
yes no
7. For women only: Are you regularly examined by a gynaecologist, including cancer screening and mammogram?
yes no Men, please click here

Personal data:



Surname*:

First name :

Street*:

Postal code, city*:

Telephone*:

E-mail*:

Message:


Please fill out all fields marked with an asterisk (*).

 

 

We want to prepare for your individual check-up.

Therefore we would ask you to answer the questions on the left.

We want your check-up to cover all possible health risks.

Address and
telephone number
for registration

DIAGNOSTIK ZENTRUM Fleetinsel Hamburg GmbH
Stadthausbrücke 3
20355 Hamburg

Tel.: 0 40 / 36 97 29-0
Fax: 0 40 / 36 97 29-22
E-mail: