Atrial Fibrillation Questionnaire
What an atrial fibrillation questionnaire asks, why each part matters, and how AFib clinics collect it.
An atrial fibrillation questionnaire, such as Eisenhower Health's AFib evaluation form, records AFib diagnosis, symptoms, heart history, past treatment, and medicines before a visit. It's also called an AFib clinic intake or an AF symptom history.
Atrial fibrillation questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on an atrial fibrillation 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 atrial fibrillation questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Has a doctor diagnosed you with AFib?Diagnosis
- When was your AFib first found?Diagnosis
- How long have you had AFib symptoms?Symptoms
- What seems to trigger your episodes?Symptoms
- Do you have heart valve disease?Heart history
- Have you had open-heart surgery?Heart history
- Have you had a cardioversion?Past treatment
- Have you had an ablation?Past treatment
- Do you take a blood thinner?Medicines
- Do you take medicine to control your heart rhythm?Medicines
- Who is your cardiologist?Care team
- When did you last see your doctor?Care team
These are examples to read, not a form to fill in.
Atrial fibrillation questionnaire: FAQ
What does an atrial fibrillation questionnaire ask?
The questions on this page follow Eisenhower Health's AFib evaluation form and heart rhythm clinic forms. They cover six areas: diagnosis, symptoms, heart history, past treatment, medicines, and care team.
Who fills in an atrial fibrillation questionnaire, and when?
A patient referred to an AFib program, before the first visit. Eisenhower Health's AFib evaluation form includes fields for a phone call's start and end time.
Is it the same as an AFib clinic intake?
Yes, AFib clinic intake is another name for it. Eisenhower Health's evaluation form also asks for the insurance carrier and the best way to contact the patient.
Which medicines does the form list?
Eisenhower Health's form lists blood thinners, rhythm medicines, beta blockers, and thyroid supplements, among others. The clinic's team reviews the list; the form gives no advice.
Is an atrial fibrillation questionnaire scored?
Not the set on this page. It records diagnosis, past treatment, and medicines before a visit, and it gives no score.
What happens after the patient answers?
The clinic's team reviews the answers and decides what happens next. AI Doctor only collects them; it does not assess symptoms or medicines.
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.
