Women's Heart Health Questionnaire
What a women's heart health questionnaire asks, why each part matters, and how practices collect it.
A women's heart health questionnaire records symptoms, heart history, menopause and pregnancy history, family history, and medications before a visit to a women's heart program. It's also called a women's cardiology intake.
Women's heart health questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a women's heart health 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 women's heart health questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Which symptom bothers you most?Symptoms
- Do you get chest pain at rest?Symptoms
- Have you had a coronary artery dissection?Heart history
- Do you have high blood pressure or cholesterol?Heart history
- Have your periods stopped, and at what age?Menopause
- Have you ever taken menopausal hormone therapy?Menopause
- How many times have you been pregnant?Pregnancy history
- Did you have preeclampsia or gestational diabetes?Pregnancy history
- Has a relative had a heart attack or stent?Family history
- How old were relatives when heart disease began?Family history
- Which prescription medicines do you take?Medications
- Do you take any non-prescription medicines?Medications
These are examples to read, not a form to fill in.
Women's heart health questionnaire: FAQ
What does a women's heart health questionnaire ask?
The questions on this page follow the Cornell Women's Heart Program and Christ Hospital Women's Heart Center forms. They cover six areas: symptoms, heart history, menopause, pregnancy history, family history, and medications.
Who fills in a women's heart health questionnaire?
The patient, before her first visit to a women's heart program. The Christ Hospital Women's Heart Center asks all new patients to complete its intake packet.
Is it the same as a cardiology new patient form?
Not exactly. It covers the same core heart history, and the Cornell and Christ Hospital forms add menstrual, menopause, and pregnancy questions.
Which pregnancy questions does it include?
The Christ Hospital form asks about high blood pressure or diabetes first found in pregnancy, preeclampsia, preterm birth, and heart failure after delivery.
Does a women's heart health questionnaire include scored questionnaires?
The Christ Hospital packet includes published questionnaires on angina, activity, mood, stress, and sleep. Each comes from its own developer, with its own terms.
What happens after the form is completed?
The cardiologist reviews the answers as part of the first evaluation. The care team decides on tests and next steps, including for any symptoms reported.
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.
