Osteoporosis Risk Assestment

1. Are you 65 years or older?

Yes No

2. Are you female?

Yes No

4. Has anyone in your family ever had osteoporosis, broken bones, or a stooped posture?

Yes No

5. Do you have a small, thin body frame or low body weight?

Yes No I don't know

6. Are you post-menopausal, currently going through menopause, or did you experience menopause early in life?

Yes No

7. Have you ever experienced the absence of normal menstrual cycles for an extended period of time (6 months or longer) because of vigorous exercise or considerable weight loss (for instance, from anorexia)?

Yes No

8. Do you have or have you ever had a diet low in calcium (for instance, are you lactose intolerant or do you have low consumption of dairy products)?

Yes No

9. Do you get very little exercise or have a sedentary lifestyle?

Yes No

10. Are you currently or have you ever been a smoker?

Yes No

11. Have you ever used medications such as steroids (for example, prednisone, dexamethasone, and others), thyroid medications, or anti-seizure medications for an extended period of time?

Yes No

12. Do you have chronic medical conditions such as cancer, thyroid disorders, Cushing's disease, asthma, or rheumatoid arthritis?

Yes No

13. Have you had broken bones (especially the hip, forearm, or spine), or do you have stooped posture, sudden back pain, or height loss?

Yes No