PCOS Intake Questionnaire
What a PCOS intake questionnaire can ask, with sample questions for fertility clinic staff.
The PCOS intake questionnaire on this page covers periods, hair growth and acne, weight, trying to conceive, health history, and medicines. Its questions are a typical set built from fertility clinic intake forms, not from a separate PCOS form.
PCOS intake questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a PCOS intake 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 PCOS intake questionnaire questions
Questions built from fertility clinic intake forms, written out so you can see the level of detail. Every practice words its own form differently.
- How often do your periods come?Periods
- Have your periods changed recently?Periods
- Do you have excess hair growth?Symptoms
- Do you have acne?Symptoms
- Has your weight changed in the past year?Weight
- Do you exercise regularly?Weight
- How long have you been trying to get pregnant?Fertility
- Have you taken Clomid or letrozole before?Fertility
- Do you have diabetes or thyroid problems?Health history
- Does anyone in your family have diabetes?Health history
- Which medicines and supplements do you take?Medicines
- Are you allergic to any medicines?Medicines
These are examples to read, not a form to fill in.
PCOS intake questionnaire: FAQ
What does a PCOS intake questionnaire ask?
The sample questions here are a typical set built from University of Rochester Medical Center and Stanford Medicine Children's Health intake forms. This page groups them into six areas: periods, symptoms, weight, fertility, health history, and medicines.
Who answers a PCOS intake questionnaire, and when?
The patient, before the fertility visit. An academic reproductive endocrinologist's intake form lists PCOS or menstrual concerns as a reason for the visit.
Is it the same as a PCOS new patient questionnaire?
It can be. In the forms used for this page, the PCOS questions sit inside the general fertility new patient form, not on a separate sheet.
Does the questionnaire ask about hair growth and acne?
Yes. The University of Rochester form asks about excess hair growth and acne, and the Stanford form lists both among past conditions.
Does the questionnaire ask about weight and exercise?
Yes. The Stanford form asks about regular exercise and weight change in the past year, and the University of Rochester form asks whether weight has changed.
What happens after a PCOS intake questionnaire?
The practice's team reviews the answers before the visit. The avatar collects them and does not link any symptom to PCOS or another condition.
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.
