Common inquiries on a health-care questionnaire include when the patient last had a comprehensive health exam, and when services such as blood tests and EKGs were last performed. Additionally, a questionnaire may inquire about family history of medical, hereditary or mental problems, according to the American Academy of Family Physicians.
Health-care questionnaires often ask whether the patient practices safe sex, and if the patient is at risk for contracting AIDS. For females, a questionnaire may ask if the patient performs a monthly self-breast exam, when a breast exam was last performed by a physician, and when a mammogram or pap smear was last performed. For males, a common question is whether the patient performs a monthly self-testicular exam, reports the American Academy of Family Physicians.
Other questions include whether the patient has ever used illegal drugs, if the patient has been exposed to radiation or chemicals in the workplace, and if the patient lives in a smoke-free home. Other lifestyle questions include whether the patient wears a helmet when riding a bicycle, and if the patient owns guns and keeps them locked and unloaded in the event that children are in the home. Additionally, a questionnaire may ask if the patient has a living will, and whether the patient balances time between work, family and hobbies, states the American Academy of Family Physicians.