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Table of Contents

  1. 5 Steps to Prepare an Effective Medical Screening Questionnaire
  2. 16+ Medical Screening Questionnaire Templates
  3. 1. Sample Medical Screening Questionnaire Template
  4. 2. Basic Medical Screening Questionnaire Template
  5. 3. Athlete Medical Screening Questionnaire Template
  6. 4. Physical Therapy Medical Screening Questionnaire Template
  7. 5. Confidential Medical Screening Questionnaire Template
  8. 6. Essential Medical Screening Questionnaire Template
  9. 7. Health Screening Questionnaire Template
  10. 8. Preventative Medicine Screening Questionnaire Template
  11. 9. Standard Medical Screening Questionnaire Template
  12. 10. Medical Screening Questionnaire Sample
  13. 11. Simple Medical Health Screening Questionnaire Template
  14. 12. Medical Screening Questionnaire & Examination Record
  15. 13. Questionnaire on Medical Screening Template
  16. 14. Physical Therapy Medical Screening Questionnaire in PDF
  17. 15. Medical Screening Questionnaire Example
  18. 16. Medical Screening Questionnaire Format
  19. 17. Simple Medical Screening Questionnaire Template

16+ Medical Screening Questionnaire Templates in PDF | Microsoft Word

A medical screening questionnaire is prepared to do the health-based assessment of a patient or an individual. The set of questions is prepared so that the doctor or the therapist can be aware of the health issues of that individual and make recommendations according to it. Here are some survey templates that can help you with the screening process. You can also see more on Medical Will.

5 Steps to Prepare an Effective Medical Screening Questionnaire

Step 1: Open a Word File

To prepare any document you have to choose a computer application that can assist you in preparing the file. MS Word Format is the best option that you can opt for when it comes to developing an official document or any document.

Step 2: Prepare a Structure

Construct the structure in which you want to present your questionnaire. The outline is the basic layout that you need to have for the screening questionnaire. Design it with your convenience.

Step 3: Design a Format

Every questionnaire has its designated format. Decide the format that you want to have for your questionnaire. Do you want to make the questionnaire more subjective or more objective or you want a balance of both? Decide and then formulate the structure accordingly.

Step 4: Write the Questions

Write down the questions following the format that you have created. If you want to make a checklist or set of reference questions you can also do that. This will make it easier for you to understand the more important questions.

Step 5: Provide Recommendations

After you are done with the screening and getting the data after the proper evaluation, provide recommendations to the individual or add suggestions that he or she can follow to make their health better.

16+ Medical Screening Questionnaire Templates

1. Sample Medical Screening Questionnaire Template

sample medical screening questionnaire templatecmpb.gov.sg
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  • PDF

Size: 133.5 KB

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For enlisting in the military you need to screen the health of all the applicants. If you want to prepare a form where you can conduct a survey, then download this Sample Medical Screening Questionnaire Template so that you can prepare a questionnaire that can bring you the health records of all the applicants. This best medical questionnaire comes with a structured format that can provide your questionnaire with a perfect dimension. You can also see more on Medical Checklists.

2. Basic Medical Screening Questionnaire Template

basic medical screening questionnaire templatesmcnd.org
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File Format
  • PDF

Size: 214.5 KB

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If you want to do a full body checkup of your patient then download this Basic Medical Screening Questionnaire Template and prepare a questionnaire that can help you develop a perfect set of questions to conduct a top to bottom check-up. This template is available in the PDF format, therefore, you can use the PDF editor to edit the content of the template and make it your required questionnaire. You can also see more on Medical Checklist in PDF.

3. Athlete Medical Screening Questionnaire Template

athlete medical screening questionnairehighperformancetri.com
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File Format
  • PDF

Size: 109.2 KB

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An athlete needs to be fit and fine. Therefore to keep your athletes free from any health issues, structure a questionnaire to get them their regular check-up. Download this Athlete Medical Screening Questionnaire Template to prepare a report where you can mention all the details related to the athlete’s health. With this template, you can prepare a medical sample note in case you need to recommend something to improve their health conditions.

4. Physical Therapy Medical Screening Questionnaire Template

physical therapy medical screening questionnaire templateadventisthealth.org
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File Format
  • PDF

Size: 315.2 KB

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If your patient is suffering from any kind of physical pain, then you will need him or her to go through certain examinations. Prepare a questionnaire that can help you with this examination process. Download this Physical Therapy Medical Screening Questionnaire Template to avail of a framework that can act as a reference to your questions. You can also see more on Medical Checklists in Word.

5. Confidential Medical Screening Questionnaire Template

confidential medical screening questionnaire templatepthealth.ca
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File Format
  • PDF

Size: 89.1 KB

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Often a full body check-up is needed before physiotherapy. Download this Confidential Medical Screening Questionnaire Template and prepare a questionnaire for the full body check-up. This medical questionnaire template is for confidential information. So if you want to keep your patient’s information confidential then this is the best template for you. You can also see more on Medical Checklist in Pages.

6. Essential Medical Screening Questionnaire Template

essential medical screening questionnaire templatevhi.ie
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File Format
  • PDF

Size: 157.8 KB

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If this is the first time you are preparing a screening questionnaire then download this Essential Medical Screening Questionnaire Template to make it as a base for the questionnaire. You can take it as an example structure to give your word document a shape. You can use the information provided in the template or modify the content as per your liking. You can also see more on Medical Checklist in Google Docs.

7. Health Screening Questionnaire Template

health medical screening questionnaire templatehamiltonymca.org
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File Format
  • PDF

Size: 209.0 KB

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You might require to do an extensive health assessment of your patient. Download this Health Screening Questionnaire Template and prepare the assessment sample report with this. The structure of this template is very flexible. Therefore you can edit the content, customize it as you desire and put it in the structure to make it a professional questionnaire. You can also see more on Health and safety plans.

8. Preventative Medicine Screening Questionnaire Template

preventative medicine screening questionnaire templatedublinprimarycare.com
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File Format
  • PDF

Size: 101.5 KB

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Before prescribing a medicine to your patient that might have certain side effects, it is better to give him certain tests. This will confirm that the patient will not have any problem if he consumes the medicine. Download this Preventative Medicine Screening Questionnaire Template and mention all the medical tests in the draft for your patient. This template is highly modifiable, therefore use this feature and make the necessary changes. You can also see more on Student Checklist.

9. Standard Medical Screening Questionnaire Template

standard medical screening questionnaire templatemountaingirlfitness.com
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File Format
  • PDF

Size: 40.9 KB

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When you train someone for a maintaining program, you need medical clearance from their physician. This will make sure that during the sample program that individual does not suffer from any medical problem. Download this Standard Medical Screening Questionnaire Template and formulate the questions whose answer you require to give that individual a clean check. With this questionnaire template, you get the sample questions that will help you decide what questions you want. You can either use them or make your questions by replacing them. You can also see more on Medical Plans.

10. Medical Screening Questionnaire Sample

bright futures medical screening questionnaire templatecdphp.com
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  • PDF

Size: 181.8 KB

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If you are preparing a questionnaire for childcare then you need to gather information about the child as well as the parents. Download this Medical Screening Questionnaire Sample to get a sample of some set of questions that can help you to do a proper sample survey. The framework of this template is versatile, therefore you can make as many changes as you want. You can also see more on Medical ID Cards.

11. Simple Medical Health Screening Questionnaire Template

simple medical health screening questionnaire templatecommittees.rcm.upr.edu
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File Format
  • PDF

Size: 268.9 KB

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If you want to assess the health conditions of the workers who work with animals, then you need to prepare the questions accordingly. Download this Simple Medical Health Screening Questionnaire Template to get a format that can frame your questions. This sample medical form is customizable. Hence you can customize it as per your preference. You can also see more on Sample Form.

12. Medical Screening Questionnaire & Examination Record

medical screening questionnaire examination record templateandark.co.uk
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File Format
  • PDF

Size: 141.0 KB

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Suppose some is learning a sea survival course. Before that, you need to get all the medical records of that person. Download this Medical Screening Questionnaire & Examination Record template to prepare that record. The structure of this template allows for making edits and modifications. So, hurry and download it now! You can also see more on Record Sheets.

13. Questionnaire on Medical Screening Template

questionnaire on medical screening templatehaaglandenmc.nl
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File Format
  • PDF

Size: 98.9 KB

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A sample simple survey questionnaire needs detailing and this is only possible when you know how to draft it. If you download this Questionnaire on Medical Screening Template you can learn the basics of drafting a professional questionnaire. The template is available with different survey questions that can provide you with a guide to prepare your questionnaire. You can also see more on Cleaning Services Survey.

14. Physical Therapy Medical Screening Questionnaire in PDF

physical therapy medical screening questionnaire template in pdfpanoramaortho.com
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File Format
  • PDF

Size: 204.1 KB

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As a physical therapist, to cure your patient if you need to prepare a sample list of tests before starting the therapy, download this Physical Therapy Medical Screening Questionnaire in PDF. This is a very efficient template. You can download any operating system. Therefore you can get it downloaded anytime and anywhere with just a single click. You can also see more on Medical Planners.

15. Medical Screening Questionnaire Example

medical screening questionnaire for low back region templatecomprehensivept.org
Details
File Format
  • DOC

Size: 4.8 KB

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A Medical Screening Questionnaire Example template has been drafted to ease the burden of our customers and release their pressure. You can download this medical simple report questionnaire if you want a ready-made template. This template is available in the Google Docs format, hence you can edit this template in the DOC editor. Stop waiting and start downloading! You can also see more on Medical Reports.

16. Medical Screening Questionnaire Format

medical screening questionnaire formatcampworkcoeman.org
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File Format
  • PDF

Size: 44.2 KB

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17. Simple Medical Screening Questionnaire Template

cryospa medical screening questionnaire templateleisureardsandnorthdown.com
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File Format
  • PDF

Size: 128.6 KB

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