1. Whom are you using this calculator for?	Yourself Family member Friend
2. How old are you? (nearest year)		Help
3. How tall are you?	Feet Inches	Help
4. How much do you weigh? (pounds)		Help
5. Are you taking a drug for osteoporosis? (List of drugs used for osteoporosis)	Yes   No	Help
6. Do you smoke now?	Yes   No	Help
7. Do you drink alcohol more than a little?	Yes   No	Help
8. Have you taken prednisone or steroid pills?	Yes   No	Help
9. Do you have rheumatoid arthritis?	Yes   No	Help
10. Have you broken bones with little injury since age 45?	Yes   No	Help
11. Has your mother or father had a hip fracture?	Yes   No	Help
12. Do you have any of the following serious chronic medical conditions? (Please check all that apply.) Diabetes requiring treatment Celiac disease Taking high doses of thyroid medication for many years Chronic liver disease Cancer Had an organ transplant Long standing malnutrition or malabsorption Serious untreated hormone deficiencies		Help
13. Are you a man or a woman?	Man  Woman
14. What race and ethnicity do you most consider fits you?	--Please select-- White Asian Black Hispanic Other