Home
Forms Library
Health history questionnaire example

Health history questionnaire 2025

health history questionnaire example Preview on Page 1

See details

4.8 out of 5

61 votes

The document is a confidential General Pre-Placement Medical History Questionnaire for the County of Los Angeles Occupational Health Programs. It requires applicants to provide personal information and answer a series of health-related questions regarding their medical history, conditions, and any previous employment with the county. The questionnaire aims to assess the applicant's fitness for a specific county position and ensure confidentiality during the examination process.

Here's how it works

01. Edit your health history questionnaire example online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send family health history questionnaire via email, link, or fax. You can also download it, export it or print it out.

The best way to change Health history questionnaire online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making changes to your documentation requires just a few simple clicks. Make these quick steps to change the PDF Health history questionnaire online for free:

Sign up and log in to your account. Sign in to the editor using your credentials or click Create free account to evaluate the tool’s features.
Add the Health history questionnaire for editing. Click the New Document button above, then drag and drop the file to the upload area, import it from the cloud, or via a link.
Adjust your document. Make any changes required: add text and pictures to your Health history questionnaire, highlight information that matters, erase parts of content and replace them with new ones, and add symbols, checkmarks, and areas for filling out.
Finish redacting the template. Save the modified document on your device, export it to the cloud, print it right from the editor, or share it with all the people involved.

Our editor is very user-friendly and efficient. Try it out now!

See more health history questionnaire versions

We've got more versions of the health history questionnaire form. Select the right health history questionnaire version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2022	4.9 Satisfied (25 Votes)
2012	4.8 Satisfied (61 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does the patient health questionnaire indicate?

The Patient Health Questionnaire (PHQ) is a new instrument for making criteria-based diagnoses of depressive and other mental disorders commonly encountered in primary care.

What is the 12 item general health questionnaire?

The 12-Item General Health Questionnaire (GHQ-12) is the most extensively used screening instrument for common mental disorders, in addition to being a more general measure of psychiatric well-being.

What is the health questionnaire?

Definition of health questionnaire A health questionnaire is a list of questions about someones health issued by underwriters before accepting a person as a risk. Failure to volunteer full information on a health questionnaire can result in coverage being voided during a claim.

What is the general health questionnaire used for?

The General Health Questionnaire (GHQ) is a screening device for identifying minor psychiatric disorders in the general population and within community or non-psychiatric clinical settings such as primary care or general medical out-patients.

What questions are on the health questionnaire?

What are the best health survey questions? How healthy would you consider yourself on a scale of 1-10? Does your family have any history of hereditary disease? Do you have any chronic diseases? Do you take any drugs? Do you drink alcohol? Do you smoke? How often do you do a health check-up?