In order to determine the best approach for treatment, it would help to have information about history and current symptoms. Therefore, it is requested that you complete this questionnaire as completely as possible before the first appointment.
Don’t worry if you are unable to recall all information requested. Good guesses or general answers are acceptable. If you feel uncomfortable answering a personal question, just leave it blank. Anticipate 10-15 minutes to complete it. There is a SAVE button at the bottom if you need to stop and come back to the form.
This questionnaire will be submitted electronically through a confidential HIPAA compliant portal directly to The Meridian Group and will only be seen by your clinician.