Este cuestionario le permite a un empleador determinar si un empleado sufre una discapacidad según la ADA para poder realizar una adaptación razonable.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés.
For your convenience, the complete English version of this form is attached below the Spanish version.
If you’re scratching your head over a question, don’t hesitate to ask your doctor or their staff for clarification. It’s better to ask than to guess!
Absolutely! Your answers are confidential and are only shared with your healthcare team to ensure the best care for you.
Expect questions about your medical history, symptoms related to diabetes, how you manage your condition, and other lifestyle factors that can affect your health.
Yes, you can often fill out the ADA Questionnaire at home before your appointment, which allows you to take your time and think through your answers.
This questionnaire helps your doctor better understand your health needs and tailor their treatment plan for you, giving them the big picture of your diabetes management.
Typically, patients who have diabetes or are at risk for it will fill out the ADA Questionnaire. It's all about getting a clear picture of their health.
The ADA Questionnaire for Physicians is a tool used to gather detailed information about a patient's medical history and current health status, particularly regarding diabetes and its management.
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Wichita Kansas Cuestionario de la ADA para médicos