Peripheral Artery Disease Questionnaire
What a peripheral artery disease questionnaire asks, with sample questions on leg symptoms, risk factors, smoking, and exercise.
A peripheral artery disease questionnaire records leg symptoms with walking, risk factors, smoking, exercise, and family vascular history before a vascular visit. The questions on this page are taken from the vascular consult and health history forms of Allina Health's Minneapolis Heart Institute and MarinHealth Medical Network.
Peripheral artery disease questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a peripheral artery 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 peripheral artery disease questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- What problems would you like to discuss today?Visit details
- Who referred you to the vascular clinic?Visit details
- Do your legs hurt when you walk?Leg symptoms
- How far can you walk before symptoms begin?Leg symptoms
- Have you ever had diabetes, and for how long?Risk factors
- Have you ever had elevated cholesterol?Risk factors
- Do you smoke now, or did you smoke before?Smoking
- Do you chew smokeless tobacco?Smoking
- Do you exercise regularly?Exercise
- What do you do for exercise?Exercise
- Has anyone in your family had leg artery bypass?Family history
- Has a relative had a leg stent or angioplasty?Family history
These are examples to read, not a form to fill in.
Peripheral artery disease questionnaire: FAQ
What does a peripheral artery disease questionnaire ask?
The sample questions on this page are based on the Allina Health Minneapolis Heart Institute vascular consult questionnaire and MarinHealth Medical Network's health history form. This page groups them into six areas: visit details, leg symptoms, risk factors, smoking, exercise, and family history.
How does it ask about leg symptoms?
The Minneapolis Heart Institute form asks about pain, numbness, fatigue, or cramping in the calves, buttocks, or thighs when walking. It also asks how far the patient can walk before this starts.
Does it ask about exercise?
The Minneapolis Heart Institute form asks how often and how long the patient walks, bikes, swims, or uses a treadmill. The MarinHealth form asks how far the patient can walk.
Who fills in a peripheral artery disease questionnaire?
The patient, before a vascular clinic visit. Both forms also ask for medicines, allergies, and past surgeries.
Is there a peripheral artery disease questionnaire template?
The sample questions on this page show a typical set. They are ordinary history questions from two vascular clinic forms, with no scoring.
What happens after the form is completed?
The vascular team reads the answers before the visit. AI Doctor only collects them and does not judge where symptoms come from.
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.
