Do you have any allergies?<br>
Are you allergic to any medications?<br>
Are you allergic to penicillin?<br>
Is your mother living?<br>
Is your father living?<br>
What did your mother die of?<br>
What did your father die of?<br>
Is there a history of diabetes/cancer/heart disease/arthritis/strokes in your family?<br><br>
What's your political affiliation?<br>
Depending on the situation (Further Questions)<br><br>

Are there things about your medical care that could be better?<br>
How many prescription medications are you taking more than three days a week?<br>
In the past year have you been in the hospital or visited an emergency room because of a chronic problem?<br>
Do you have one person you think of as your personal doctor or nurse?<br>
How easy is it for you to get medical care when you need it?<br>
How confident are you that you can control and manage most of your health problems?<br>
When you visit your doctor's office, how often is it well organized, efficient and not a waste of your time?<br>
When you think about your health care, how much do you agree or disagree with this statement: "I receive exactly what I want and need exactly when and how I want and need it."