The Administrative Center allows forms to be sent to patients to be completed electronically before their appointment.
List of available patient forms
Here is the complete list of available patient forms (last update: November 22, 2024).
Generic:
- ABCdaire - Family Questionnaire
- AUDIT - Alcohol Use Disorders Identification Test
- ASRS-V1.1 - Adult ADHD Self-Report Scale
- Arthritis - Patient global assessment of disease activity
- BASDAI : Bath Ankylosing Spondylitis Disease Activity Index
- BASFI : Bath Ankylosing Spondylitis Functionnal Index
- CADDRA
- DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure - Adult
- Epworth Sleepiness Scale
- GAD-7
- Gynécologie - Questionnaire patiente (French only)
- HAQ - Health assessment questionnaire (this form has been restructured to make it more suitable for sending to patients)
- Headache Impact Test (HIT6)
- IPSS - International Prostate Symptom Score
- PHQ-9
- Physical Activity Barriers Questionnaire - SEP-Barr
- Simple Physical Activity Questionnaire (SIMPAQ)
- SNAP-IV 26 - ADHD Rating Scale
- STOP BANG questionnaire (Sleep apnea)
- WSAS, WSAS-P, WSAS-Y
Specific:
- Consentement à l'utilisation de renseignements - Personne mineure - École de Kinésiologie de l'UdeM (French only)
- Consentement à l'utilisation de vos renseignements personnels - École de kinésiologie de l'UdeM (French only)
- Functional Abilities Form - Concordia
- Information pour la participation à une consultation en présentiel ou virtuel - UdeM (French only)
- Politique d'annulation/absence/report de rendez-vous - École de kinésiologie de l'UdeM (French only)
- Politique d'annulation/absence/report de rendez-vous - Mon Kin - École Kinésiologie de l'UdeM (French only)
- Questionnaire santé - École de kinésiologie de l'UdeM (French only)
New forms to integrate?
📒 New forms will be added over time.
If you would like an existing clinical tool to be integrated into the patient form, you can send your suggestions by contacting support by chat or email.
Does your clinic require patients to fill out special forms before their appointment? Use our billable services to help your team integrate them.