ocr: Complete and review with your pharmacist WOMEN AND HEART HEALTH INFORMED DECISIONS PERSONAL PROFILE Patient Name: Family History (1st degree relative) Date of Birth: Today's Date Pharmacist: Hypertension Yes a No a Dyslipidemia Yes a No D Personal History (If: yes - specify treatment, details Or date) Angina Yes a No D Ticker Test Score Past Heart Attack Yes a No D Height Weight BMI Ifyes, male < 55 yrs? Yes a No D Allergies Yes a No a Ifyes, female < 65 yrs? Yes a Nol D Hypertension Yes D No a TIAS Yes a No a Dyslipidemia Yes a No a Stroke Yes a No D Angina Yes a No D Diabetes Yes a No a MI Y ...
