Patient Intake
Medical Questionnaire
Please complete this questionnaire before your appointment. It helps us prepare for your visit and ensures the best possible care.
Patient Intake Form
The Summit Health intake questionnaire will be embedded here on the live site.
[ Patient intake form widget, to be added by Summit Health ]
If you have questions, reach us at 1-888-224-8809 or support@summithealth.ca
What to expect
The medical questionnaire takes approximately 5 to 10 minutes to complete. We ask about:
- Your medical history and current health conditions
- Medications you currently take
- Allergies (especially to medications, latex or contrast)
- Recent surgeries or hospitalizations
- For specific services: relevant additional details (e.g., recent travel, infusion history)
All information is private, encrypted, and PHIPA compliant. Your responses are reviewed by your clinical team before your appointment.
Why we ask
Knowing your medical history helps us:
- Avoid medication interactions
- Plan the safest treatment approach
- Save time during your in-clinic visit
- Coordinate with your other healthcare providers
Your health. Our expertise. One connected experience.
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