Repository Questionnaire (Attending Physician) - Pru Life UK 2026

1. Click ‘Get Form’ to open the Repository Questionnaire in our editor.
2. Begin by entering the Proposed Life Insured's full name and date of birth in the designated fields. Ensure accuracy for proper identification.
3. Select the type of respiratory disorder from the provided options. This is crucial for categorizing the patient's condition.
4. Fill in the frequency of episodes, along with the dates of onset, first consultation, and last attack. These details help assess the patient's medical history.
5. Answer questions regarding the severity of the condition, treatment details, functional capacity limitations, and any complicating features such as smoking or occupation.
6. Utilize the space provided to elaborate on previous answers or add any additional comments about the patient’s ability to manage their condition.
7. Finally, ensure that you sign and date the form at the bottom to affirm that all information is complete and accurate.

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