Delays in completing the forms may result in an incomplete assessment of your longevity profile. While the questions are in English, you can answer in German, English or French.
Your main reason for today’s visit, along with a complete list of any prescription medications, over-the-counter drugs, vitamins, and supplements you are currently taking.
Any significant medical conditions that run in your family, including illnesses affecting parents, siblings, or close relatives. Because many health risks have a genetic component, being as detailed and precise as possible is important.
Tell us about your exercise habits, how well and how long you usually sleep, and your typical diet. Include any use of recreational drugs, alcohol, or tobacco.
Share information about your relationships, living situation, emotional well-being, and stress levels. Include details about your sexual health and any relevant behaviors.
List any past health screenings, vaccinations, or preventive care you have received. Include how often you follow routines like blood pressure checks, dental visits, or cancer screenings.
For women only: Provide details about your menstrual cycle, menopause status, or any pregnancies. Include relevant symptoms, complications, or changes over time.
