To ensure that we have a comprehensive understanding of your health conditions and concerns, please take the time to complete the following questionnaire. Your input is crucial in helping us provide you with the best possible care. We kindly request that you be thorough and check all applicable conditions. If you have any reservations or specific issues you would like to discuss with the doctor regarding this questionnaire, please inform the nurse. Your open communication is essential in tailoring our services to meet your individual needs.