Patient Health Survey (Medical history)
You can fill out this form with your health information before you arrive for your doctor’s appointment to save time and trouble in the waiting room. Simply print out the form, complete it at your convenience, and bring it with you to your appointment. Do not fill out this form online and do not e-mail it to us. If you are unable to print the form, plan to arrive for your appointment a few minutes early to allow time to complete the Patient Health Survey in your doctor's office
Click here to view and print the form.
