I think it would help if you included an explanation of why this is important!
This questionnaire is to help you and I understand your health concerns. If you prefer not to answer a question, please leave it blank. You are not obligated to complete this form.
User keys to online intake form, that loads spreadsheet database, which will ultimately be accessible via owner-only web pages.
Please check the types of health care practitioners you have seen or are seeing.
Check if you've had recent bloodwork done, and please bring a copy of the results with you to our visit.