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Questionnaires

Your doctor or nurse may ask you to complete a questionnaire.

ALCOHOL CONSUMPTION

Please answer the questions in the short questionnaire to enable us to assess your alcohol consumption rate and offer advice if necessary.

Alcohol Consumption Questionnaire

FOR PATIENTS WHO ARE DUE AN ASTHMA REVIEW

Please would you answer the questions on the form below and submit it to us.

If your symptoms are deteriorating or you have any concerns, please make an appointment to the respiratory nurse or a doctor as well.

Open the Asthma Annual Review Form

DEPRESSION ASSESSMENT QUESTIONNAIRE

This easy to use patient questionnaire has been validated for use in Primary Care.

It is used by your doctor to monitor the severity of depression and response to treatment.

It can also be used to make a tentative diagnosis of depression.

PHQ-9 Depression Assessment Questionnaire

FOR PATIENTS TAKING THE CONTRACEPTIVE PILL

Please print off this questionnaire, complete it and return it to us if you are taking the contraceptive pill.  We need to have an up to date blood pressure reading every 12 months.

Questionnaire for patients taking the contraceptive pill



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