Innovation in Next Generation Sequencing

Making Genomics Available and Affordable for Everyone

Wellness Research Program

    Online Wellness Research Program
    By checking this field you agree to participate in GTC's Online Wellness Research Program

    Gender
    MaleFemale

    Race/Ethnicity
    American Indian or Alaska Native onlyAsian OnlyNative Hawaiian or Other Pacific Islander onlyBlack or African American onlyWhite onlyHispanic or Latino2 or more races

    Education

    Family Income
    Thousands $

    Family Type

    Country of Birth
    USOutside US

    Disability Status
    Without DisabilitiesWith Disabilities

    Sexual Orientation
    Straight MaleStraight FemaleGay/LesbianBisexual

    Marital Status

    Do You Currently Smoke?
    NoYesOccasionally

    Do you have an immediate family member who has developed heart disease Before the age of 65?

    Would you describe the amount of weekly exercise that you get as low (less than 30 minutes of physical activity on most days)?
    NoYes

    Has a blood test in recent years shown that you have high cholesterol?
    NoYes

    Has a blood test in recent years shown that your  LDL is too high?
    NoYes

    Has a blood test in recent years shown that your HDL is too low?
    NoYes

    Has a blood test in recent years shown that you have high triglycerides?
    NoYes

    Is your blood pressure greater than 140/90 or higher?
    NoYes

    What is your blood pressure?
    Diastolic Systolic

    Does your diet consist of high-fat foods?
    NoYes

    Do you ever experience rapid fatigue, shortness of breath, or light-headedness from modest physical exertion, such as walking or climbing stairs?
    NoYes

    In recent years, have you fainted?
    NoYes

    Have you ever experienced symptoms of angina (pain, heaviness, or discomfort in your chest – or arm or jaw pain, or pain around the shoulder blades), especially with exertion?
    NoYes

    If you previously smoked, has it been less than five years since you quit?
    NoYes

    Have you gone for years without regular medical check-ups?
    [radio years-w/o-checkup default:1 "No" "Yes"]

    Do you have diabetes?
    NoYes

    Have you ever had a stroke?
    NoYes

    Have you ever had symptoms of a “temporary” or “mini” stroke (temporary weakness in an arm or leg, or difficulty speaking that is otherwise unexplained)?
    NoYes

    Would describe the stress levels in your life as high?
    NoYes

    Averaged, do you have the equivalent of more than one drink of alcohol per day?

    Have you been previously tested for clonal hematopoiesis?
    NoYes

    If answered yes, was it positive?
    NoYes

    What are your Test Values:

    Hemoglobin?
    g/dl

    Hematocrit?
    %

    Red blood cell count?
    mcL

    White cell count?
    mcL

    Platelet count?
    mcL

    Lymph percentage?
    %

    Mono percentage?
    %

    Granulocytes percentage?
    %

    What is your cholesterol?
    mg/dL

    What is your LDL?
    mg/dL

    What is your HDL?
    mg/dL

    What is your Triglycerides?
    mg/dL

    How tall are you?
    inches

    Date of Birth?

    Your weight?
    pounds