Health Maintenance and Physical Examinations
Here are some suggestions to get you started:
First, remember that the reason you are doing this questionnaire is to provide your doctor with information that you think is important for your care. Be sure to be as specific as you can about your concern.
Please DO NOT type Medication Refill, as medication refills should be requested through the Virtual Office Visit
You can list as many concerns as you like, separated by commas or by the word "and". If you think that two concerns are related to each other, use only the main one. For example if you have a cough and a fever, but you think that the fever might be caused by the cough, enter "cough" as your concern. The questionnaire will ask you about your fever automatically.
If your doctor suggested you come to our site to do a questionnaire, he or she may have suggested a concern for you to enter. Be sure to use that concern as a starting point, although you can enter other concerns in addition.
Be sure that your sex and age are correct. The questionnaires are designed differently depending on your age and sex.
Here are some common concerns and the words you should enter in order to start that questionnaire:
- Headache – type in "headache"
- Cough with or without fever, sputum or trouble breathing – type in "cough"
- Any kind of joint swelling, pain, or difficulty moving joints – type in "joint pain"
- Back pain in any part of the back – type in "back pain"
- Discomfort or burning when you urinate, any trouble urinating, possible urine infection – type in "difficulty urinating"
- Any problems with your bowel movements – type in "stools"
- Ear pain, with or without fever, discharge – type in "earache"
- Routine examination – type in "physical exam"
- Trouble sleeping – type in "insomnia"
- Nervous, anxious, unable to focus or concentrate – type in "anxiety"
- Depressed, down, unable to get going – type in "depression"
- Dizzy, lightheaded, trouble with balance – type in "dizzy"
- Hypertension, high blood pressure – type in "high blood pressure"
- Diabetes or concern about possible diabetes – type in "diabetes"
- Pediatric well child visits (up to age 10) – type in the child's age followed by "well child". For example "4 month well child" for a 4 month old follow up visit.
- Abdominal gas, bloating, burping, belching – type in "bloating"
- Difficulty swallowing food or drinks – type in "difficulty swallowing"
- Cold, sore throat, sinus problem – type in "URI"
- Menstrual period abnormality – type in "periods"
- Finally, if you do a questionnaire, and it turns out not to be the right one to address you concerns, you have the option to return to start over with a new concern.

