How to Conduct a Medical Questionnaire

Medical issues are often sensitive. It is therefore important for researchers to capably know how to conduct a medical questionnaire. Medical questionnaires are typically used to asses the health conditions of individuals for various reasons ranging from employment to fitness programs.

Medical questionnaires should be highly confidential owing to the private and sensitive content that they request for. Knowing how to conduct a medical questionnaire involves structuring questions in a way that will sufficiently establish how healthy the respondent is for a particular purpose. Knowledge of how to conduct a medical questionnaire constitutes an assessment that is comprehensive enough for conclusive results to be made.

Sample How to Conduct a Medical Questionnaire

This is a sample of a medical questionnaire.

Name __________________

Address __________________

Telephone Number __________________

Email Address __________________

Age __________________

Marital Status __________________

Please tick against any medical conditions that you may have suffered from:

Diabetes __________________

Chronic coughing __________________

Back pains __________________

Pneumonia __________________

Epilepsy __________________

Heart Disease __________________

Hypertension __________________

Urinary Tract Infection __________________

Asthma __________________

Anemia __________________

Have you been treated by a specialist?

  1. Yes
  2. No

Are you currently undergoing any health assessment?


Are you currently undergoing any form of treatment?


If yes above, please specify __________________

Have you undergone surgery before? If yes, please state when and why __________________

Have you been involved in an accident and suffered any serious injuries?


Are you using any prescribed medication at the moment?


Please describe how you generally feel about your health __________________

Do you smoke? If yes, how often do you smoke?


Are you aware of any health conditions that are prevalent in your family? If yes, please specify


Category: Medical Questionnaire

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