EWellness Questionnaires
Please select the appropriate questionnaire below, print, and complete questionnaire prior to visiting Dr. Gochee.
Questionnaire files are in .pdf file format. If your computer does not have Adobe Reader, please click on the Get Adobe Reader button to download Adobe Reader.
- Abdominal Pain/Cramps
- Allergies/Asthma
- Arthritis Profile
- Autoimmune Disease
- Back Pain/Neck Pain
- Bronchitis/Cough
- Cancer Profile
- Cholesterol Problems
- Chronic Fatigue Syndrome
- Chronic Urinary Tract Infections
- Cold or Flu
- Comprehensive
- Constipation
- Crohn’s Disease
- Decreased Sex Drive
- Dementia/Memory Problems
- Depression
- Diabetes/Metabolic Syndrome Profile
- Diarrhea
- Dizziness/Vertigo/Light Headed
- Dry Skin/Brittle Nails
- Ear Ache/Ear Infection
- Edema
- Endometriosis
- Energy with Problems/Fatigue
- Fibromyalgia
- Food Intolerance/Food Allergies
- Headaches/Migraines
- Heart Disease Profile
- Heartburn/Reflux/Gerd
- Hypertension
- Infertility
- Irritable Bowel
- Lung Problems
- Macular Degeneration Profile
- Nausea/Vomiting
- Numbness/Tingling
- Osteoporosis Profile
- Pain/Inflammation
- PMS/Irregular Periods
- Prostate Health Profile
- Rash/Warts/Skin Conditions
- Sciatica/Disc Herniation
- Sinus/Nasal Congestion
- Sleeping Problems
- Sore Throat
- Stress/Anxiety
- Thyroid Problems
- Weight Gain
- Wrist/Hand Pain
- Yeast Infection