Pre-Assessment Health Questionnaire

Please complete this questionnaire ahead of your Advanced Health Assessment (AHA). It takes most people 15–25 minutes and can be done on a phone, tablet, or computer in one sitting.

Your privacy

Your information is stored securely on Canadian servers(Montreal, Canada) in compliance with Nova Scotia's health-privacy legislation (PHIA & PIIDPA).
Your submission is automatically deleted 30 days after it is delivered to the clinic. Signature Health keeps your assessment record in their own medical system.
You can withdraw consent at any time. If you'd rather not use this online form, you can download a PDF version instead.

By continuing, you consent to Signature Health collecting and storing the information in this questionnaire for the purpose of your assessment. Read our privacy policy.

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