Stroke Risk Assessment

Understanding your stroke risk is the first step to prevent it. By completing this brief assessment, you can learn more about your risk factors of stroke.

I have read the Personal Data Protection Notice provided by SunMed Velocity Sdn Bhd pursuant to Section 7 of the Personal Data Protection Act 2010, which includes purposes for which my personal data and sensitive personal data are collected / processed and classes of third parties to whom SunMed Velocity Sdn Bhd will / may disclose my personal data and sensitive personal data to.

I verify that the personal information provided in this form is accurate and up-to-date. If completing this form on behalf of others, I confirm I have their consent or the legal right to share their information with the Hospital.

I acknowledged that this self-assessment for stroke risk factors is intended for informational and educational purposes only. The results of this assessment are not a substitute for professional medical advice, diagnosis, or treatment. This assessment is designed to help you identify potential risk factors and encourage you to seek further evaluation from a qualified healthcare provider.

Agree

Disagree

Personal Details

Full Name (As per NRIC/Passport No.)

Phone Number

Email Address (optional)

Assessment Progress Indicator

0%

1. What is your age range?
Below 55 years old
55 years old and above

2. What is your gender?
Male
Female

3. Does your average blood pressure exceed 140/90 mmHg?
Yes
No
Not Sure

4. Have you ever been diagnosed with diabetes?
Yes
No

5. Are you a smoker?
Yes
No

6. Have you ever been diagnosed with myocardial ischaemia (heart attack) and/or atrial fibrillation (irregular heart rhythm) ?
Yes
No

7. What is your current height & weight?

Please input your answer below:

Height Centimeter (cm)

Weight Kilogram (kg)

Your BMI Result : -

8. Do you carry out at least 150 minutes of physical exercise within a week?
Yes
No

9. Does any of your family members has a history of stroke?
Yes
No

10. Have you recently experienced any sudden onset of the following symptoms?
Blurring of vision
Facial drooping
Arm weakness/numbness
Speech difficulties
None of the above

RESULT

Your risk of stroke might be low.

Continue maintaining a healthy lifestyle. If you have any questions regarding stroke, please book an appointment with our consultant neurologist.

Book an Appointment

Disclaimer: The self-assessment for risk factors of stroke provided is intended for informational and educational purposes only. The results of this assessment are not a substitute for professional medical advice, diagnosis, or treatment. This assessment is designed to help you identify potential risk factors and encourage you to seek further evaluation from a qualified healthcare provider.

Your risk of stroke might be high.

We highly encourage you to sign up for the SMCV Stroke Risk Assessment Package. Get your stroke risks assessed further by our consultant neurologist at our Stroke Care Centre today.

Stroke Risk Assessment Package

Disclaimer: The self-assessment for risk factors of stroke provided is intended for informational and educational purposes only. The results of this assessment are not a substitute for professional medical advice, diagnosis, or treatment. This assessment is designed to help you identify potential risk factors and encourage you to seek further evaluation from a qualified healthcare provider.

You may have experienced minor stroke.

It is recommended that you seek immediate medical attention. Get your stroke risk assessed further by our consultant neurologist.

Book an Appointment

Disclaimer: The self-assessment for risk factors of stroke provided is intended for informational and educational purposes only. The results of this assessment are not a substitute for professional medical advice, diagnosis, or treatment. This assessment is designed to help you identify potential risk factors and encourage you to seek further evaluation from a qualified healthcare provider.