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A questionnaire used to gather family medical history and patient information relevant to maternal-fetal medicine, aiding in determining potential needs for additional testing.
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How to fill out Screening Questionnaire

01
Start by carefully reading the instructions provided at the top of the Screening Questionnaire.
02
Gather any required personal information such as your name, age, and contact details.
03
Review each question individually, ensuring you understand what is being asked.
04
Answer each question truthfully; if unsure, consult with a reliable source if possible.
05
Double-check your answers and make sure all necessary questions are completed.
06
Submit the questionnaire as instructed, either online or through other provided methods.

Who needs Screening Questionnaire?

01
Individuals seeking to assess their health or eligibility for specific programs.
02
Patients preparing for medical evaluations or treatments.
03
Participants in research studies that require preliminary screening.
04
Organizations needing to gather basic information before providing services.
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People Also Ask about

Screening questions (also known as "screeners") either qualify or disqualify respondents from taking your survey—depending on how they answer. They let you decide who takes your survey based on the target audience you want to hear from.
The most commonly used drug use screening tests include: Drug Abuse Screen Test (DAST, also known as DAST-10). This test contains 10 yes or no questions about how much and how often you take drugs. It also asks if the drugs are causing problems in your life and health.
Patient Health Questionnaire-9 (PHQ-9) ShareThe PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression.
PHQ-9 scores can be used to plan and monitor treatment. To score the instrument, tally the numbers of all the checked responses under each heading (not at all=0, several days=1, more than half the days=2, and nearly every day=3). Add the numbers together to total the score on the bottom of the questionnaire.
Screening questions need to be short and easy for respondents to answer. They should avoid binary response options but also should not include too many response options. You should order the response options in the right way, and the overall screener shouldn't contain too many questions.
The Patient Health Questionnaire 9-item depression scale (PHQ-9) and 7-item Generalized Anxiety Disorder scale (GAD-7) are among the best validated and most commonly used depression and anxiety measures, respectively.
Translated versions of the PHQ-9 scale The PHQ-9 has been translated into the following languages and is available on the Pfizer website. It is strongly recommended that these questions are completed with a health professional. For other languages, visit Patient Health Questionnaire (PHQ) Screeners(external link).

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A Screening Questionnaire is a tool used to gather preliminary information from individuals to determine their eligibility or suitability for a specific purpose, such as participation in a study, project, or compliance with regulations.
Individuals or organizations that are participating in programs, research studies, or regulatory processes that require assessment for eligibility or compliance are typically required to file a Screening Questionnaire.
To fill out a Screening Questionnaire, individuals should carefully read the instructions, provide accurate and complete information as requested in each section, and ensure all required fields are addressed before submitting.
The purpose of a Screening Questionnaire is to collect essential data that can help determine an individual’s or organization’s eligibility, identify potential issues, and facilitate decision-making processes.
Information typically required on a Screening Questionnaire may include personal identification details, background information, qualifications, specific eligibility criteria, and any pertinent disclosures relevant to the assessment.
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