Screening Tools

Lifestyle Risk Screening Tool

Health Behavior Assessment)

AUDIT (Alcohol Use Disorders Identification Test) (source: World Health Organization)

Physical Activity Readiness Questionnaire (source: Exercise is Medicine)

Wellness Questionnaire and Action Plan (English), Wellness Questionnaire and Action Plan (Spanish) (source: Hennepin County SHIP)

Adult Pre-Visit Planner (source: Hennepin County SHIP)

Clinic Height/Weight Measurement Protocol (source: Park Nicollet Health Services)



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Should you require a reasonable accommodation in order to fully participate, or information in an alternative format, please contact 612-673-2301. 

Para asistencia 612-673-2700 - Rau kev pab 612-673-2800 - Hadii aad Caawimaad u baahantahay 612-673-3500

Last updated Jan 25, 2017



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For employees

For reasonable accommodations or alternative formats, contact 311.
People who are deaf or hard of hearing can use a relay service to call 311 at 612-673-3000.
TTY users can call 612-673-2157 or 612-673-2626.

Para asistencia 612-673-2700, Yog xav tau kev pab, hu 612-637-2800, Hadii aad Caawimaad u baahantahay 612-673-3500. 


311 call center

TTY relay service


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