Initial Health Assessment

Health Questionaire
Virtual: Global
Service placeholder illustration

This questionnaire is designed to gather essential information about your health for our preventive health clinic. By completing this questionnaire, we can assess your overall well-being, identify potential risk factors, and address any health concerns you may have. Please make sure to answer each question accurately. The purpose of this questionnaire is to personalize the preventive screening protocol according to your individual health needs and risks.


  • Personal information (such as age, gender, and contact details)
  • Medical history (including any past illnesses, surgeries, or chronic conditions)
  • Current medications and supplements
  • Lifestyle habits (such as diet, exercise, smoking, and alcohol consumption)
  • Family medical history (to assess genetic predispositions and hereditary conditions)

Not included

  • Detailed physical examination
  • Laboratory tests or diagnostic procedures
  • In-depth psychological assessment
  • Treatment recommendations or prescriptions
  • Emergency medical care
  • Any clinical assessment of the data provided
Cookie policy undecided

We use cookies to offer you a better browsing experience, analyze site traffic and personalize content. Read about how we use cookies by clicking