Patient Questionnaire

A complete overview of your medical history and symptoms will help Dr. Gagnon identify the best course of treatment in a timely manner.

Please fill out the “Medical History and Symptom Questionnaire” found below and bring it with you to your first appointment.

For Females:
Download Female Medical History and Symptom Questionnaire (PDF)

For Males:
Download Male Medical History and Symptom Questionnaire (PDF)