What is a Medical Questionnaire

A medical questionnaire plays an important role in identifying the medical history of a patient or an individual. This type of exercise is normally conducted by medical institutions, government agencies, hospitals, and health care institutions and it helps the agencies to determine what forms of health care is available to people and what more they need. A medical questionnaire can be filled by an individual as well as his or her family members and it comes in handy for medical care professionals during examinations, diagnosis, and treatment of the individual or his/her family members.

A medical questionnaire normally contains questions related to all aspects of a human body, diseases, ailments, and medical conditions. It is divided into primarily two sections and they are:

  • Personal Information: This is the first section of a medical questionnaire and it contains personal information related to an individual or the participant or patient. Personal information includes name, age, sex, marital status, contact information, date of last physical checkup, name of family physician, members in the family, name of spouse and children, their personal information, and information regarding their medical insurance and provider. This information is important because it helps hospitals and other medical institutions in updating and maintaining a record of each of the individuals or patients. This type of information is also helpful when a patient or individual requires emergency medical care.
  • Medical Information: This is the second section of the medical questionnaire. It contains information related to the medical history of the individual, patient or participant and the family medical history as well. In this part of the questionnaire, the participant has to provide information regarding the total medical visits they have made in a year, the cost of healthcare for the entire family, the nature of medical care, the various ailments and medical condition prevalent in the family like blood pressure, diabetes etc., treatments followed in the past, current or existing treatment or therapy, and current medical condition.

Category: Sample Questionnaire

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