1 Questions.pdf

QUESTIONS ASKING INFORMATION Name

DOB Marital status Address Phone number Email Mother’s/father’s name Emergency contact Medical history Allergies Medication you are taking GP

QUESTION 1. 2. 3. 1. 2. 3. 1. 2. 1. 2. 3. 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. 1. 2. 1.

May I have your full name? Can I have your full name? Could you please tell me your full name? When were you born? May I have your date of birth? Can I have your date of birth? What is your marital status? Are you married? Where do you live? May I have your address? Could you tell me your address? May I have your phone number? Can I have your phone number? May I have your email address? Can I have your email address? May I have your mother’s name? What is your mother’s name? In case of any emergency, do you have any other contacts number? May I have your another contact in case any emergency situation? Do you have any illness in the past? Do you have any allergies? Are you allergic to. . . Are you taking any medication now? Are you using any drugs for medication now? Who is your GP?