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Osteoporosis Risk Assesment

OSTEOPOROSIS RISK ASSESSMENT FORM

Medications:

Do you have family history of osteoporosis?

Do you exercise?

Are you a postmenopausal woman?

Do you take thyroid medications regularly?

Have you had other fractures since age 50?

Do you smoke or take tobacco?

Is your diet low in dairy products & other sources of calcium?

Thank you for taking our survey.

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