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Bone Densitometry Examination questionnaire Name: Sex: FM Current Height: Date of Birth: Weight: Referring MD: Menopause Age: Ethnicity: 1. Have you had a previous hip or vertebral (spine) fracture?
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Bone densitometry examination questionnaire is a form used to gather information about a patient's bone density and assess their risk of fractures.
Patients who are recommended by their healthcare provider to undergo a bone densitometry examination are required to fill out the questionnaire.
The questionnaire should be filled out by providing accurate information about personal and medical history, medications, and lifestyle habits.
The purpose of the questionnaire is to help healthcare providers assess the patient's bone health, identify risk factors, and possibly diagnose osteoporosis.
Information such as personal medical history, family history of fractures, current medications, and lifestyle habits should be reported on the questionnaire.
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