Get Dexa Bone Density Screening Patient Questionnaire

Filling out the DEXA Bone Density Screening Patient Questionnaire online is an essential step in assessing your bone health. This guide will provide you with clear and supportive instructions to help you complete the form accurately and efficiently.

Follow the steps to complete your questionnaire with ease.

1. Click ‘Get Form’ button to access the DEXA Bone Density Screening Patient Questionnaire. This will open the document in your preferred editing platform.
2. Begin by entering your name in the designated field. This personal information is required for identification purposes.
3. Next, provide your date of birth. This information helps healthcare providers assess your risk factors accurately.
4. Record today’s date in the specified area to indicate when you filled out the questionnaire.
5. Answer the question regarding pregnancy by checking 'YES' or 'NO' based on your current status.
6. Indicate whether you have any metal in your spine and/or hips by selecting 'YES' or 'NO'.
7. Respond to the question about past bone fractures. If applicable, specify which bone was broken.
8. Specify whether you were a child (20 or younger) or an adult when the fracture occurred by marking the appropriate box.
9. Indicate your alcohol consumption by answering whether you consume alcoholic beverages and, if so, the number of drinks per day.
10. Answer questions about your medication history related to seizures, epilepsy, and convulsions by marking the applicable boxes.
11. If applicable, indicate whether your menstrual cycles are regular, and provide details about any hysterectomy you may have undergone.
12. Indicate if you have gone through menopause and at what age, if relevant.
13. Answer questions regarding steroid use for chronic conditions and any intestinal problems you may have.
14. Provide information about your smoking status and if you have a family history of osteoporosis.
15. Indicate any changes in height you may have experienced and whether you take medication for thyroid problems.
16. Answer questions about your dietary intake of calcium and whether any healthcare provider has diagnosed you with osteopenia or osteoporosis.
17. Specify your medication for osteopenia or osteoporosis if applicable.
18. Indicate if you have experienced falls without a specific reason and provide information about any renal failure or dialysis treatment.
19. Finally, answer questions regarding the use of birth control pills, hormone replacement therapy, calcium pills, and vitamin intake.
20. Once you have completed the questionnaire, review your answers for accuracy. You can then save the changes, download, print, or share the document as needed.

Complete your DEXA Bone Density Screening Patient Questionnaire online today!