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Patient Questionnaire - Hospital for Special Surgery - hss 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your personal information in the 'Patient Data' section, including your name, date of birth, and contact details.
  3. Indicate your dominant hand and gender. This information helps the medical team understand your preferences.
  4. In the 'Chief Complaint' section, describe your main health issue clearly. Use the space provided to detail any symptoms and their onset.
  5. Complete the pain drawing by marking areas where you feel pain and rate your pain levels on a scale from 0 to 10 for different scenarios.
  6. Fill out the medical history sections regarding past tests, treatments, and current medications. Be thorough to ensure accurate care.
  7. Review all sections for completeness before submitting. Ensure that all required fields are filled out accurately.

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