ImproveCareNow

To use Improve Care Now's Health Tracker for Crohn's Disease, simply answer the questions on the form below, click the "Get My Health Score!" submit button, and receive a Health Score. You may even print or email your information to yourself if you’d like to have it available to look at later.

Note: All questions, except email address, are required.

Question 1
In the last week, I felt:
'well'  'fair'  'bad' 

Question 2
In the last week, has Crohn’s disease kept you from your regular activities?
No, there have been no limitations (I have been able to do what I usually do-go to school, play, do after school activities or sports)  Yes, there has been some limitation of my activity (I can go to school but I have not been able to play or do after school activities or play sports at least once in the last week)  Yes, there have been severe restrictions of my activity (I had to miss school or could not do other important activities) 

Question 3
Have you had abdominal pain (stomach aches, cramps, gas pains) in the last week? Thinking about the worst day in the last week, please describe your pain:
None (I did not have any pain)  Mild (I had mild pain that I could ignore)  Moderate to severe (I had pain that I could not ignore) 

Question 4.a
Are you losing weight even when you were not trying to?
No  Yes, I have lost a little weight when I was not trying to  Yes, I have lost a lot of weight when I was not trying to 

Question 4.b
In Question 4.a above, if you answered "Yes, I have lost a lot of weight when I was not trying to," how many pounds did you lose?

Question 5
What have your poops been like in the last week? On an average each day you had:
No liquid poops or 1 liquid poop without blood each day  1 or 2 poops with a small amount of blood each day  2, 3, 4, or 5 liquid poops without blood each day  2, 3, 4, or 5 liquid poops with blood each day  6 or more liquid poops with or without blood each day  A lot of blood  I wake up at night to go to the bathroom to poop 

First Name *

Age *

Email Address
Enter only if you want your results emailed to you. Your email address is used only to email your score to you and is not collected. No personally identifiable information will be emailed.

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