CareRequest

Select Monitor

Preview CareRequest

Grant Access
When did your symptoms start?
How long have you had these symptoms?
Have you had this symptom before?
How long did it last?
What treatment did you take for those previous symptoms?
How would you rate your pain on a scale of 1 to 10 (10 being the highest)?
Describe any changes in the symptom since it started.
What do you think caused your symptoms?
Describe any existing health issues.
State any medication you have?
State any allergies you have.
Give detail of any illness in the last 4 weeks.
What help do you need with this symptoms
Do you have any images of your symptoms?
Click to
upload
Add More
In order for healthcare professionals to understand your situation better, it is advisable to add your last 4 weeks health monitor readings with this CareRequest, are you happy for them to be included?