My Weight in pounds is:
My height in inches is:
My BMI* is:

My Weight puts me at an/a increased  high    very high extremely high  risk for health problems.

Using the Weighing Your Risk chart to calculate.

Information from my primary health care provider.

My blood pressure is:
My blood cholesterol is:
My BMI* is:
My HDL cholesterol is:
My LDL cholesterol is:
My blood triglygeride level is:
My fasting blood sugar is:

* If your health care provider says these values are outside healthy ranges, you can improve them by losing and maintaining a moderate weight loss goal of five to 10 percent of your body weight, and increasing your physical activity level.