top of page

Acute care questionnaire

tips for filling out the form

Avoid listing general symptoms like “cough”, “fever”, “sore throat’.

Tell me all about your cough.    Tell me all about your fever.     Tell me all about your throat.

Describe sensations so I know what your symptom feels like to YOU.

Use as many details as possible.
Paint me a picture of your experience of suffering.

Answer all the questions.

What makes it better and worse?!

Think about it like this:


What does your headache n-e-e-d? Pressure? Stillness? Does it want the heat of the shower?

Do you want to lay it on something cold?

Press it with your hand?

Take a hot shower?

Those things are examples of what makes it better…

I’m sure you know what makes it worse.

Lights, noise, turning your head.

bottom of page