Get the free Sexual History Questionnaire - Community Health Centers

Sexual History Questionnaire **Must be completed for all patients age 13 and above** Patient Name: Patient Gender: M F Patient DOB: LMP: Have you had sex in the last 12 months (vaginal; oral; or,

How to fill out sexual history questionnaire

How to Fill out Sexual History Questionnaire:

1. Read the questionnaire: Start by carefully reading through the sexual history questionnaire to familiarize yourself with the questions and structure. This will help you understand what information is required and how to provide accurate answers.
2. Provide accurate information: It is important to provide honest and accurate information when filling out a sexual history questionnaire. This includes details about your sexual activity, past or current sexually transmitted infections (STIs), contraceptive methods used, and any relevant medical history.
3. Take your time: Take your time to think and reflect on the questions asked in the questionnaire. It is essential to provide thoughtful and accurate responses. If necessary, take breaks and return to it later to ensure your answers are comprehensive and accurate.
4. Maintain confidentiality: Sexual history questionnaires are strictly confidential, and the information you provide should remain private. Remember that healthcare professionals use this information to provide appropriate care and guidance, so be assured that your privacy will be respected.

Who Needs a Sexual History Questionnaire?

1. Patients seeking sexual healthcare: Sexual history questionnaires are commonly used when patients visit healthcare providers for comprehensive sexual healthcare or STI testing. By gathering this information, doctors can assess risks, provide appropriate advice, and offer suitable treatment options based on the patient's sexual history.
2. Individuals engaging in sexual relationships: It is recommended that individuals who are sexually active, or planning to be sexually active, fill out a sexual history questionnaire. This allows them to understand their own sexual health status, communicate openly with partners about potential risks, and take necessary precautions to protect themselves and others.
3. Researchers and healthcare professionals: Sexual history questionnaires can also be utilized by researchers and healthcare professionals to gather data for studies, establish patterns or trends related to sexual health, and design targeted interventions or education programs to promote healthy sexual behaviors.

In summary, filling out a sexual history questionnaire involves carefully reading and providing accurate information. These questionnaires are beneficial for patients seeking sexual healthcare, individuals engaging in sexual relationships, and researchers hoping to improve sexual health outcomes. Remember, being honest and thorough with your responses will help healthcare professionals provide appropriate care and support.

For pdfFiller’s FAQs

What is sexual history questionnaire?

The sexual history questionnaire is a document that collects information about an individual's sexual activity and health.

Who is required to file sexual history questionnaire?

Individuals who are seeking medical treatment or participating in certain research studies may be required to fill out a sexual history questionnaire.

How to fill out sexual history questionnaire?

To fill out a sexual history questionnaire, individuals must truthfully answer all the questions about their sexual activity, health, and any relevant medical history.

What is the purpose of sexual history questionnaire?

The main purpose of a sexual history questionnaire is to gather information that can help healthcare providers make informed decisions about a patient's care, diagnosis, and treatment.

What information must be reported on sexual history questionnaire?

Information such as sexual partners, sexual practices, history of sexually transmitted infections, contraceptive use, and any relevant medical conditions must be reported on a sexual history questionnaire.

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