Geriatrics Health Questionnaire
A health questionnaire that may be completed before a geriatric medicine assessment.
About the questionnaire
Patients attending a geriatric medicine assessment may be asked to complete a health questionnaire before their appointment. The questionnaire helps gather relevant background about medical history, medications, daily function and other health considerations so that the assessment can be focused and efficient.
What it may cover
Depending on the reason for the visit, the questionnaire may include questions about:
- Current and past medical conditions
- Medications, supplements and allergies
- Mobility, balance and daily activities
- Memory and cognitive concerns
- Mood and overall well-being
- Social and living situation
Download the Questionnaire
Download the geriatrics health questionnaire to complete before your assessment. If you have an upcoming appointment, our team will advise whether a questionnaire should be completed beforehand.
Have an Upcoming Appointment?
If you are preparing for a geriatric medicine assessment and have questions about what to complete beforehand, please contact the clinic.
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