{"id":66918,"date":"2019-01-23T21:14:11","date_gmt":"2019-01-24T05:14:11","guid":{"rendered":"https:\/\/www.questionpro.com\/blog\/?p=66918"},"modified":"2023-06-30T21:12:16","modified_gmt":"2023-06-30T21:12:16","slug":"health-history-questionnaire","status":"publish","type":"post","link":"https:\/\/www.questionpro.com\/blog\/health-history-questionnaire\/","title":{"rendered":"Health History Questionnaire: 15 Must-Have Questions"},"content":{"rendered":"<h2><b>What is a Health History Questionnaire?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">A health history questionnaire consists of a set of <\/span><a href=\"https:\/\/www.questionpro.com\/article\/survey-question-answer-type.html\"><span style=\"font-weight: 400;\">survey questions<\/span><\/a><span style=\"font-weight: 400;\"> that help either medical researcher, doctors or medical professional, hospitals or small clinics to understand the population they provide medical services to. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Using a <\/span><a href=\"https:\/\/www.questionpro.com\/blog\/what-is-a-questionnaire\/\"><span style=\"font-weight: 400;\">questionnaire<\/span><\/a><span style=\"font-weight: 400;\"> makes it easy to collect and analyze data for anything that can be as simple as college <\/span><a href=\"https:\/\/www.questionpro.com\/blog\/what-is-research\/\"><span style=\"font-weight: 400;\">research<\/span><\/a><span style=\"font-weight: 400;\"> or developing break-through medical developments. To treat a patient optimally a doctor must know the details of his\/her medical history. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">For example, some patients can be highly allergic to aspirin, which is a commonly used drug for treating cough and cold, mild fever, toothache etc. This should be known to the treating doctor. This information can be obtained from the patients or study subjects for clinical trials if they fill out a detailed <\/span><a href=\"https:\/\/www.questionpro.com\/blog\/what-is-a-questionnaire\/\"><span style=\"font-weight: 400;\">questionnaire<\/span><\/a><span style=\"font-weight: 400;\">. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Here are some of the must-have questions in a health history questionnaire. <\/span><\/p>\n<h3><b>15 Must-Have Questions in a Health History Questionnaire<\/b><\/h3>\n<h4><strong>A. Demographic Questions<\/strong><\/h4>\n<p><a href=\"https:\/\/www.questionpro.com\/blog\/demographic-survey-questions\/\"><span style=\"font-weight: 400;\">Demographic questions<\/span><\/a><span style=\"font-weight: 400;\"> are an important aspect of a <a href=\"https:\/\/www.questionpro.com\/survey-templates\/health-care-surveys\/\">health care survey<\/a> history questionnaire. These questions are designed to help the researcher determine what factors might influence the respondent&#8217;s decision-making abilities. Collecting demographic information will help you <\/span><a href=\"https:\/\/www.questionpro.com\/cross-tabulation.html\"><span style=\"font-weight: 400;\">cross-tabulate<\/span><\/a><span style=\"font-weight: 400;\"> the information and compare it with other subgroups and see if responses vary between these groups. <\/span><\/p>\n<ol>\n<li><strong> What is your age?<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Under 18 years <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">18-24 years <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">25-34 years <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">35-44 years <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">45- 54 years <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">55-64 years old <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Above 64 years <\/span><\/li>\n<\/ul>\n<ol start=\"2\">\n<li><strong> Please specify your ethnicity<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">White <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Hispanic or Latino <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Black or African-American<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Native American or American Indian <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Asian<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Pacific Islander <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Other <\/span><\/li>\n<\/ul>\n<ol start=\"3\">\n<li><strong>Please select your highest level of education<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">No schooling completed <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Some high school or diploma <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">High school graduate <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Professional\/Vocational\/Technical Training<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Bachelor\u2019s degree <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Master\u2019s degree <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Doctorate degree <\/span><\/li>\n<\/ul>\n<ol start=\"4\">\n<li><strong> What is your marital status?<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Single, never married <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Married or domestic partnership <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Widowed <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Separated <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Divorced <\/span><\/li>\n<\/ul>\n<ol start=\"5\">\n<li><strong> Please specify your employment status<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Unemployed but looking for work <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Self-employed <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Out of work but looking for work <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A student <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Homemaker <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Military <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Retired <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Unable to work<\/span><\/li>\n<\/ul>\n<h4><strong>B.\u00a0Heath History Questions<\/strong><\/h4>\n<ol start=\"6\">\n<li><strong> Have you ever been treated in an emergency room?<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">No <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Yes, as a child <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Yes, as an adult<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Emergency rooms can be a place where there are memorable memories created or horrifying experiences gained, patients usually remember their ER experiences. As a researcher or a medical professional know why the patient(s) was there. <\/span><\/p>\n<ol start=\"7\">\n<li><strong> Have you ever been rushed to the hospital in an ambulance? If Yes, do you remember why?<\/strong><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">This is an <\/span><a href=\"https:\/\/www.questionpro.com\/blog\/what-are-open-ended-questions\/\"><span style=\"font-weight: 400;\">open-ended question<\/span><\/a><span style=\"font-weight: 400;\"> that will help an individual answer elaborately. Collecting important information is essential to understand if the individual has been through a certain experience and what were those like. Ride in an ambulance is during dire emergencies. If the individual has been through experience then it is essential to know why. <\/span><\/p>\n<ol start=\"8\">\n<li><strong> Have you ever had an allergic reaction to\u2026<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Food <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Drug <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Insect <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Substance <\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">In the majority of cases, this question focuses more on the allergic reaction caused due to drugs. But it is important to know if a person is allergic to food products, certain types of insects or even substances like latex etc. Knowing allergic reaction have proved to save the lives of 17% Americans in 2018. <\/span><\/p>\n<ol start=\"9\">\n<li><strong> Do you carry any medication in case of an emergency?<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nitroglycerine <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Glucose <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Insulin <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Inhaler <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Epi-Pen <\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">This question is an important part of the health history questionnaire. This covers conditions that are or might be a part of a patient\u2019s life that becomes an unconscious thought and they conveniently forget that they even have such a condition. For a patient to carry nitroglycerine for heart problem has become a habit. Only if they experience pain they are reminded of the condition they have. <\/span><\/p>\n<ol start=\"10\">\n<li><strong> Do you wear any medical jewelry like a bracelet?<\/strong><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">This is a question similar to the above question. However, this is also one of the important questions that should be asked without fail. There are a number of medical conditions that need a patient to wear medical jewelry to help others identify if they have an existing condition. The jewelry may be a part of the patient\u2019s everyday life and he\/she can get quite used to it. <\/span><\/p>\n<ol start=\"11\">\n<li><strong> Have you ever received stitches?<\/strong><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">The need for stitches can range from a variety of reasons, cuts that might have resulted during playing casually to accidents. It is important to know the answer to this question as the situation could also be an outpatient surgery. <\/span><\/p>\n<ol start=\"12\">\n<li><strong> Have you taken tetanus in the last year?<\/strong><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Tetanus is an injection shot that you take when you step on a rusted nail or experience a cut from a rusted edge, dog bite etc. Information related to this can be helpful to identify past injuries or emergencies. <\/span><\/p>\n<ol start=\"13\">\n<li><strong> Have you ever been admitted to the hospital?<\/strong><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Stroke <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Childbirth <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Accident <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tests <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Observation <\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Psychiatric observation <\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Admission to the hospital for tests or general observation can be overlooked in comparison to childbirth and surgery. Some patients are not very comfortable sharing their mental health history unless they are questioned directly or more authoritatively. Information of this degree needs to be present on papers for a doctor to treat a patient fairly. <\/span><\/p>\n<ol start=\"14\">\n<li><strong> Have you experienced a fracture or sprain?<\/strong><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">If a patient has had a broken bone or few broken bones they usually tend to remember it. If the answer to this question is yes then ask them specifically which part of the body they broke a bone or two and how many times. <\/span><\/p>\n<ol start=\"15\">\n<li><strong> Have you ever been denied medical insurance?<\/strong><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Permanent conditions, disabilities, pre-existing conditions are a few reasons why an individual can be denied medical insurance. These conditions can be identified with this question. Disqualification means the patient must be suffering from a condition and may be totally unaware of it and not even realized the reason for disqualification. <\/span><\/p>\n<h3><b>Tips to Write a Smart Health History Questionnaire<\/b><\/h3>\n<ol>\n<li><span style=\"font-weight: 400;\"><strong> Know your target audience<\/strong>: Know the people you want to gather information from. Ask only those questions that are absolutely essential. Asking vague questions can result in respondent leaving the absolutely essential questions as well, this is known as <a href=\"https:\/\/www.questionpro.com\/blog\/what-is-survey-dropout-analysis\/\">survey dropout<\/a>. In conditions like these, you will not get the appropriate information you are looking for. <\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> Clearly define your questions<\/strong>: It is important that you ask clear questions. Consider using combinations of <\/span><a href=\"https:\/\/www.questionpro.com\/close-ended-questions.html\"><span style=\"font-weight: 400;\">close-ended questions<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.questionpro.com\/blog\/what-are-open-ended-questions\/\"><span style=\"font-weight: 400;\">open-ended questions<\/span><\/a><span style=\"font-weight: 400;\">. This way you will be able to gather maximum information from your respondents. <\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> Questionnaire length<\/strong>: Remember you are collecting vital information. Make sure your <\/span><a href=\"https:\/\/www.questionpro.com\/blog\/what-is-a-questionnaire\/\"><span style=\"font-weight: 400;\">questionnaire is designed<\/span><\/a><span style=\"font-weight: 400;\"> in such a manner that it doesn\u2019t cause questionnaire boredom to your respondents. Again please don\u2019t use medical jargons that might confuse your patients. <\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> Keep your records updated<\/strong>: Asking your patient the same everytime they visit you may get them irritated. Keep your records and data updated. Any questionnaire is deployed with the purpose of collecting first-hand information to make informed decisions. Please do not defeat this purpose. <\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>What is a Health History Questionnaire? A health history questionnaire consists of a set of survey questions that help either [&hellip;]<\/p>\n","protected":false},"author":86,"featured_media":66919,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[238],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Health History Questionnaire: 15 Must-Have Questions | QuestionPro<\/title>\n<meta name=\"description\" content=\"A health history questionnaire consists of a set of survey questions that help either medical research, doctors or medical professional, hospitals or small clinics to understand the population they provide medical services to. 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In this blog, you will read the 15 must-have questions in your health history questionnaire.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.questionpro.com\/blog\/health-history-questionnaire\/\" \/>\n<meta property=\"og:site_name\" content=\"QuestionPro\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/questionpro\" \/>\n<meta property=\"article:published_time\" content=\"2019-01-24T05:14:11+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-30T21:12:16+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.questionpro.com\/blog\/wp-content\/uploads\/2019\/01\/Health-History-Questionnaire.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"992\" \/>\n\t<meta property=\"og:image:height\" content=\"594\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Adi Bhat\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@questionpro\" \/>\n<meta name=\"twitter:site\" content=\"@questionpro\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Adi Bhat\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.questionpro.com\/blog\/health-history-questionnaire\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.questionpro.com\/blog\/health-history-questionnaire\/\"},\"author\":{\"name\":\"Adi Bhat\",\"@id\":\"https:\/\/www.questionpro.com\/blog\/#\/schema\/person\/6240dce6e1901b1a6c7f3dbd3e22567f\"},\"headline\":\"Health History Questionnaire: 15 Must-Have Questions\",\"datePublished\":\"2019-01-24T05:14:11+00:00\",\"dateModified\":\"2023-06-30T21:12:16+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.questionpro.com\/blog\/health-history-questionnaire\/\"},\"wordCount\":1136,\"publisher\":{\"@id\":\"https:\/\/www.questionpro.com\/blog\/#organization\"},\"articleSection\":[\"Questionnaire\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.questionpro.com\/blog\/health-history-questionnaire\/\",\"url\":\"https:\/\/www.questionpro.com\/blog\/health-history-questionnaire\/\",\"name\":\"Health History Questionnaire: 15 Must-Have Questions | QuestionPro\",\"isPartOf\":{\"@id\":\"https:\/\/www.questionpro.com\/blog\/#website\"},\"datePublished\":\"2019-01-24T05:14:11+00:00\",\"dateModified\":\"2023-06-30T21:12:16+00:00\",\"description\":\"A health history questionnaire consists of a set of survey questions that help either medical research, doctors or medical professional, hospitals or small clinics to understand the population they provide medical services to. 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