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General Health Questionnaire. Eastside Sports Rehabilitation Clinic. Patient: Age : . Diagnosis or Problem Area: Please complete this questionnaire so .

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How to fill out the General Health Questionnaire 12 Pdf Download online

Filling out the General Health Questionnaire 12 is crucial for ensuring you receive the best possible care. This guide provides clear, step-by-step instructions for completing the questionnaire online, making the process easier for all users.

Follow the steps to successfully complete the questionnaire.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by filling in your personal information in the designated fields. Provide your name and age accurately, as this information is essential for your healthcare provider.
  3. In the diagnosis or problem area section, specify any relevant medical diagnosis or concerns you have. Be as detailed as possible to ensure accurate care.
  4. Carefully read through the list of health problems. Check all boxes that apply to you now or have troubled you in the past. This section helps your healthcare team understand your medical history.
  5. Answer the questions regarding smoking habits and exercise frequency. If you exercise, note how often. This information is crucial for developing a suitable treatment plan.
  6. Indicate if you experience shortness of breath with exertion. This is important for assessing your cardiovascular health.
  7. For individuals who may be pregnant, please answer the question about the possibility of pregnancy. This information is vital for appropriate care.
  8. List any medications you are currently taking. Include prescription and over-the-counter medications to provide your provider with a comprehensive view of your health.
  9. On a pain scale from 1 to 10, indicate the intensity of your pain when it occurs. This helps gauge the severity of your condition.
  10. Identify activities that worsen or alleviate your injury or problem area. This information will assist your healthcare provider in understanding your limitations and needs.
  11. If you have other special problems or concerns, please describe them in the provided space. This ensures that no critical information is overlooked.
  12. Once you have filled out the entire form, review your responses for accuracy. Make any necessary adjustments.
  13. Finally, save your changes, and then choose to download, print, or share the completed form as needed.

Start filling out your General Health Questionnaire online today to ensure you receive personalized care.

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GHQ scoring (0-0-1-1). ... Likert scoring (0-1-2-3) Modified Likert scoring (0-0-1-2) C-GHQ scoring (0-0-1-1) for positive items, where agreement indicates health, and 0-1-1-1 for negative items, where agreement indicates illness).

Background. The twelve-item General Health Questionnaire (GHQ-12) is intended to screen for general (non-psychotic) psychiatric morbidity [1]. It has been widely used and, as a result, translated into many languages and extensively validated in general and clinical populations worldwide [2].

The General Health Questionnaire (GHQ) is a measure of current mental health and since its development by Goldberg in the 1970s it has been extensively used in different settings and different cultures [1-5].

The General Health Questionnaire (GHQ-12) consists of 12 items, each assessing the severity of a mental problem over the past few weeks using a 4-point scale (from 0 to 3). The score was used to generate a total score ranging from 0 to 36, with higher scores indicating worse conditions [14].

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232