Medicare wellness questionnaire medical care 2026

1. Click ‘Get Form’ to open the Medicare Annual Wellness Visit Questionnaire in the editor.
2. Begin by filling out the 'Providers and Suppliers of Your Medical Care' section. List all relevant healthcare providers, including primary care physicians and specialists.
3. In the 'Current Medications' section, enter all medications you are currently taking, including prescriptions and over-the-counter drugs. Be sure to include dosage and frequency.
4. Complete the 'Medication Allergies' section by listing any known allergies along with their reactions.
5. Proceed to your medical history. Check the boxes for any conditions that apply to you, such as diabetes or heart disease.
6. Fill out your surgical history by indicating any past surgeries and providing comments if necessary.
7. Continue through sections on family history, social habits, and health risk assessments, ensuring all fields are completed accurately.
8. Finally, review your entries for accuracy before signing and dating the form at the end.

Start using our platform today to easily complete your Medicare wellness questionnaire online for free!