Home
Forms Library
Health risk assessment form

Health risk assessment 2026

health risk assessment form Preview on Page 1

See details

4.4 out of 5

123 votes

The document is a Health Risk Assessment for the Healthy Michigan Plan, aimed at gathering personal health information to better meet the health needs of beneficiaries. It emphasizes the importance of annual check-ups, confidentiality of provided information, and offers assistance for completing the form. The assessment includes questions about general health, lifestyle habits, and readiness to change unhealthy behaviors. It also outlines steps for beneficiaries and their primary care providers to complete the assessment and highlights potential rewards for maintaining healthy behaviors.

Here's how it works

01. Edit your health risk assessment form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send printable health risk assessment form via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out health risk assessment with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Health Risk Assessment in the editor.
Begin with Section 1, where you will answer initial assessment questions. Rate your health and respond to questions about exercise, diet, and tobacco use. Select the appropriate options based on your recent experiences.
Proceed to Section 2, where you will schedule your annual appointment. Enter the date of your appointment and note any topics you wish to discuss with your doctor.
In Section 3, reflect on your readiness to change health behaviors. Use the scale provided to indicate your interest in making lifestyle changes and the support you expect from family, friends, or healthcare providers.
Finally, Section 4 is for your primary care provider. Ensure they complete this section during your appointment, including their signature and date.

Start filling out your Health Risk Assessment today for free using our platform!

See more health risk assessment versions

We've got more versions of the health risk assessment form. Select the right health risk assessment version from the list and start editing it straight away!