Adult Congenital Heart Disease Questionnaire
What an adult congenital heart disease questionnaire asks, with sample questions for congenital heart clinics.
An adult congenital heart disease questionnaire such as UAB's Adult Outpatient Data Form records the visit reason, medicines, heart history, family history, and habits. It's also called an ACHD clinic intake or a congenital heart follow-up questionnaire.
Adult congenital heart disease questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on an adult congenital heart disease questionnaire in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample adult congenital heart disease questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Why are you here to see the cardiologist?Visit reason
- Is this your first visit to this clinic?Visit reason
- What medicines do you take, including birth control?Medicines
- Are you allergic to any medicines?Medicines
- Has a cardiologist diagnosed heart disease before?Heart history
- Which heart operations have you had, and where?Heart history
- Has a relative had heart disease before 50?Family history
- Does anyone in your family have a genetic syndrome?Family history
- Do you exercise, and what type?Social history
- How many pregnancies have you had?Social history
- Which doctors care for you outside this clinic?Other doctors
- Which of your doctors should get our reports?Other doctors
These are examples to read, not a form to fill in.
Adult congenital heart disease questionnaire: FAQ
What does an adult congenital heart disease questionnaire ask?
The questions on this page follow UAB's Adult Outpatient Data Form. They cover six areas: the visit reason, medicines, heart history, family history, social history, and other doctors.
Who fills in an adult congenital heart disease questionnaire?
The adult patient, before the clinic visit. The practice decides whether the questions go out ahead of the visit or are asked at check-in.
Who is an adult congenital heart clinic for?
Adults who were born with a heart defect. A Nova Scotia Health guide says its clinic sees patients 16 or older, who often need monitoring for life.
Is it the same as a congenital heart follow-up questionnaire?
It can be. UAB uses one form for both: new patients list earlier diagnoses and operations, and returning patients list illnesses since the last visit.
Why does the form list other doctors?
So the clinic can send its office reports to each doctor the patient sees. UAB's form also has a separate page naming the people the clinic may speak with.
What happens after an adult congenital heart disease questionnaire is completed?
The cardiology team reviews the answers before the visit. Any question about pregnancy, medicines, or tests is for the cardiologist to answer.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
