Health Questionnaire
Going to see the doctor often makes people very anxious. They are asked a lot of questions and, because they are anxious, often important things are forgotten.
We find that it helps if people have few minutes to think about their answers to some of the questions.
To help you do this we have prepared this questionnaire. Would you mind taking a few minutes to read it and answer the questions as accurately as you can? In this way we can be of most help to you.
You may find that some of the questions do not seem to be related to the problem for which you came to see us. But these, too, are important. Each system in the body interacts with others. So problems in one system, now or in the past, can affect the function of others. This means that we have to take an overview to be able to really find out what is wrong and how best to help you.
Like the rest of your medical record, the questionnaire is, of course, strictly confidential. The information will not be given out to anyone without your permission.
If you don't understand some of the questions or how to fill in the questionnaire, please ask us for help.
Click below to download the Questionaire in one of the following formats and bring it to the appointment with you.
PDF FORMAT | WORD FORMAT
Dr. Michel Rathbone