Health survey template
This health survey is designed to gather demographic details, lifestyle habits, medical history, and screening test outcomes, aiming to evaluate an individual's overall health and identify any possible health concerns.
Additionally, it collects contact information for the individual's primary care physician, ensuring seamless coordination and communication regarding the patient's health status.
Template tags
Health survey
Example questions
Demographic Information:
Lifestyle Habits
Medical History
Symptoms
Screening Tests
Overall Health
Contact Information
Health Survey Template Builder
Discover LimeSurvey's health survey builder and create surveys that will help you gather valuable insights on the demographics, lifestyle habits, medical history, and overall health of your patients, enabling you to provide more personalized and effective care.
- Easy and simple to use
- Statistics
- Questionnaire templates
- GDPR compliance
- So much more…
Related form templates
This survey is about measuring an individual's level of happiness through various factors such as emotional well-being, ...
The survey aims to gather information on an individual's happiness scale and life satisfaction while also providing opportunities for growth and improvement.
The health history questionnaire gathers vital information about a patient's personal medical history, family health bac ...
It also captures their reproductive and sexual history, and vaccination records, assisting healthcare professionals with indispensable information for accurate diagnosis and effective treatment planning.
The stress survey template is designed to collect data on individuals' stress levels, what contributes to these levels, ...
The gathered data offers valuable insights that can guide individuals on how to improve their emotional well-being and overall quality of life, by suggesting potential changes to decrease their stress levels.
The objective of this healthcare survey template is to measure patient satisfaction, assess the quality of care provided ...
By gauging communication efficacy with healthcare providers, the survey aims to enhance healthcare outcomes and enrich the overall patient experience.
This healthcare survey template covers an array of topics including the overall patient experience, the specific departm ...
It also solicits patient feedback on their involvement in decision-making, their likelihood of recommending the service, along with their suggestions for improvement and any additional comments.
This survey template gauges the ease with which patients can make appointments, the professionalism and friendliness of ...
It also evaluates patients' likelihood to recommend the healthcare services to others, enabling a comprehensive understanding of patient satisfaction and experience.
This survey aims to gather information about people's physical fitness and exercise habits, including their motivation f ...
It also seeks feedback on what types of fitness services people are likely to participate in and any suggestions for better supporting their physical fitness goals.
Best Healthcare Questionnaires and Feedback Form Templates
LIMESURVEY IS TRUSTED BY THE WORLD'S MOST CURIOUS MINDS:
