Medical questionnaire: How are you?

The secure medical questionnaire below will allow you to tell us! We ask you to fill it out to the best of your knowledge. Once completed, you can email it back to us. If you prefer, you can complete this questionnaire by hand at the clinic the day of your appointment, in that case, please plan on arriving 20 minutes before the time of your appointment.

IMPORTANT: Once you have completed the form, don't forget to click the Submit button below the last question to send us your answers.