
G 46 Medical anamnesis of musculoskeletal disorders (anamnesis questionnaire 2) Surname First name Address: street Postcode, town Employer Address: street Postcode, town Initial examination Follow-up.
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How to fill out the Anamnesis Questionnaire 2 - DGUV online
Completing the Anamnesis Questionnaire 2 - DGUV is an essential step in assessing musculoskeletal disorders related to work. This guide provides a clear, step-by-step approach for filling out the questionnaire effectively and accurately.
Follow the steps to complete the Anamnesis Questionnaire 2 - DGUV online.
- Press the ‘Get Form’ button to access and open the Anamnesis Questionnaire 2 - DGUV in your online editor.
- Begin with the personal information section. Fill in your surname, first name, address (street and postcode), employer's name, and their address (street and postcode). Indicate whether this is for the initial examination, follow-up examination, or examination when leaving the job.
- In the section regarding the character of the pain, choose the appropriate box to describe your pain or symptoms in the arms and legs, muscles, or spinal column. You can select multiple descriptors such as dull pain, stabbing pain, or muscle weakness.
- Describe the occurrence of shooting pains, if any, by selecting 'Yes' or 'No' and indicating which parts of the body they radiate to.
- Assess the provokability of the pain by concluding whether certain activities like coughing, straining, or working with vibrating tools provoke it. Again, choose 'Yes' or 'No'.
- Indicate if your symptoms improve when you are away from work by selecting the appropriate option and providing further details if necessary.
- Rate the intensity of your worst pain experienced in the last 30 days on a scale from 0 to 10, where 0 indicates no symptoms and 10 represents the worst pain imaginable.
- Document the weekly prevalence of pain or symptoms experienced in the last 7 days, marking the affected areas in the body.
- Provide further anamnestic information regarding pain characteristics, provokability, previous treatment, diagnoses, and any medications or conditions that might affect your symptoms.
- Lastly, ensure the document is signed and dated by the physician, confirming the accuracy of the information provided.
Complete your Anamnesis Questionnaire 2 - DGUV online to ensure accurate documentation of your health status.
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