Health Screen

This Health Screen is designed by Therapeutic Meals' dietitian Jenneke van Hemert, RD.

The survey screens for risk factors that may impact your nutrition status and well-being. The health screen looks for changes in weight, healthy weight range, appetite, risk for hospital admission, frailty, chewing or swallowing difficulty and emotional health. 

No data is being collected, saved, or shared in any capacity. The purpose is only to inform.

If you have any questions about this screen, or your results, please contact Jenneke at 250 415 5444.

 

 

Enter your weight

in pounds
or
in kilograms.

Enter your height

in feet and inches
or
in centimeters.

 

 

Have you lost weight recently without trying within the last 6 months?


Yes, how much:



 

Choose the statement below that best fits the scenario:

 My appetite is good, I f
 I
 I e
 I eat less than usual, about
 I am s

 

Click any that apply to you:



 

Choose one that describes you best:

 I am
 I am 
 I am 

 

Are you avoiding certain foods? Mark the statements that apply to you:

 I like
 I a
 I a
 I a
 I l
 It f

 

Click any that apply to you:



 I feel sad all the time.
 
 I am mainly staying inside by myself.
I recently lost a loved one and am now by myself.
 I am