Patient Questionnaires for Care Visits
If you were asked to fill out a questionnaire before your appointment, you may look it up by department or specialty. Print, fill in your responses, and take to your visit.
All questionnaires are in PDF format.
These questionnaires are for preventive care appointments with your primary care provider.
Women's Health Care/Gynecology
For visits with a women's health care provider about a health problem or concern:
Women's Health Care
(For a preventive care visit with a women's health care provider, fill out the appropriate questionnaire in the Primary Care section.)
Other Departments and Specialties
Choose your questionnaire by the department or specialty where your appointment is scheduled.
Activity, Sport, Exercise Medicine (ASEM); North Region*
Activity, Sport, Exercise Medicine (ASEM); South Region**
Behavioral Health Services
Internal Medicine, Consultative
Neurosurgery Spine Center
Orthopedics; North Region*
Orthopedics; South Region**
Physical Medicine & Rehabilitation⁄Pain
Medical Centers with orthopedic and ASEM specialists:
*North Region: Seattle and Bellevue medical centers
**South Region: Tacoma, Olympia, Port Orchard, and Silverdale