Get the free CHA2DSVASC Questionnaire

Name: Fillable Online CHA2DSVASC Questionnaire Fax Email Print - pdfFiller
Brand: pdfFiller
Rating: 4.8 (30 reviews)

Get Form

Show details

PRIVATE AND CONFIDENTIALCHA2DS VASC Questionnaire Name: ___Age: ___Gender: F/MSurgery: ___ Dr: ___ Date: ___PLEASE ENSURE YOU ANSWER ALL QUESTIONS. Do you have a history of: Congestive Heart FailureHypertensionStroke

We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign cha2dsvasc questionnaire

Edit your cha2dsvasc questionnaire form online

Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature

Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly

Email, fax, or share your cha2dsvasc questionnaire form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit cha2dsvasc questionnaire online

Ease of Setup

pdfFiller User Ratings on G2

Ease of Use

pdfFiller User Ratings on G2

To use the professional PDF editor, follow these steps:

1

Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.

2

Upload a file. Select Add New on your Dashboard and upload a file from your device or import it from the cloud, online, or internal mail. Then click Edit.

3

Edit cha2dsvasc questionnaire. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.

4

Save your file. Select it in the list of your records. Then, move the cursor to the right toolbar and choose one of the available exporting methods: save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud.

With pdfFiller, it's always easy to work with documents.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.

Learn more about security & compliance

How to fill out cha2dsvasc questionnaire

01

Provide patient's age (Aged 65-74 = 1 point, Aged 75+ = 2 points)

02

Check for the presence of hypertension (1 point)

03

Check for the presence of congestive heart failure (1 point)

04

Check for the presence of vascular disease (1 point)

05

Check for the presence of diabetes (1 point)

06

Check for the presence of stroke or TIA (2 points)

07

Check for the presence of female gender (1 point)

Who needs cha2dsvasc questionnaire?

01

Patients with atrial fibrillation who are considering anticoagulation therapy

Fill form : Try Risk Free

Rate the form

4.8

Satisfied

30 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

How can I modify cha2dsvasc questionnaire without leaving Google Drive?

Simplify your document workflows and create fillable forms right in Google Drive by integrating pdfFiller with Google Docs. The integration will allow you to create, modify, and eSign documents, including cha2dsvasc questionnaire, without leaving Google Drive. Add pdfFiller’s functionalities to Google Drive and manage your paperwork more efficiently on any internet-connected device.

Can I create an electronic signature for signing my cha2dsvasc questionnaire in Gmail?

Use pdfFiller's Gmail add-on to upload, type, or draw a signature. Your cha2dsvasc questionnaire and other papers may be signed using pdfFiller. Register for a free account to preserve signed papers and signatures.

How do I edit cha2dsvasc questionnaire straight from my smartphone?

The best way to make changes to documents on a mobile device is to use pdfFiller's apps for iOS and Android. You may get them from the Apple Store and Google Play. Learn more about the apps here. To start editing cha2dsvasc questionnaire, you need to install and log in to the app.

What is cha2dsvasc questionnaire?

The CHA2DS2-VASc questionnaire is a clinical tool used to assess the risk of stroke in patients with atrial fibrillation. It assigns points based on various risk factors to help guide the decision for anticoagulation therapy.

Who is required to file cha2dsvasc questionnaire?

Patients diagnosed with atrial fibrillation or atrial flutter are typically required to be assessed using the CHA2DS2-VASc questionnaire to evaluate their risk of stroke.

How to fill out cha2dsvasc questionnaire?

To fill out the CHA2DS2-VASc questionnaire, healthcare providers evaluate the patient's medical history and assign points based on specific criteria, such as age, sex, and presence of comorbid conditions.

What is the purpose of cha2dsvasc questionnaire?

The purpose of the CHA2DS2-VASc questionnaire is to stratify a patient's risk of stroke and guide appropriate therapeutic decisions, particularly regarding anticoagulation therapy.

What information must be reported on cha2dsvasc questionnaire?

Information that must be reported includes the patient's age, sex, history of heart failure, hypertension, diabetes, previous stroke or TIA, vascular disease, and any other relevant medical conditions.

Fill out your cha2dsvasc questionnaire online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now