LETS TAKE A GUESS
FILL IN THE BLANK
HAS TO CONTAIN QUESTIONNAIRE IN ANSWER
COMMON QUESTIONNAIRES
THINGS YOU MIGHT NOT KNOW
100

A QUESTION ON THIS QUESTIONNAIRE IS           ANY PHYSICAL OR SPEECH THERAPY NEEDED?

WHAT IS STROKE QUESTIONNAIRE?

100

WHEN FILLING OUT QUESTIONNAIRES ______BLANKS SHOULD BE FILLED IN

WHAT IS ALL?

100

CLIENT STATES HAS BACK SPASMS

WHAT IS BACK/JOINT QUESTIONNAIRE?

100

PARENTS NATURAL DEATH COVERAGE IS IMPORTANT IN WHICH QUESTIONNAIRE

WHAT IS CHILD COVERAGE QUESTIONNAIRE?

100

HOW MANY DIFFERENT TYPES ON ARTHRITIS ON THE ARTHRITIS QUESTIONNAIRE

WHAT IS 3?

200

FOR A PERSON THAT HAS ADHD THIS TYPE OF QUESTIONNAIRE IS NEEDED

WHAT IS THE DEPRESSION QUESTIONNAIRE?

200

CLIENT STATES THEY HAVE HEART ________ AND THE AGENT WILL HAVE TO FILL OUT A HEART MURMUR QUESTIONNAIRE

WHAT IS MURMUR?


200

A SMALL FAMILY THREE JUST HAD A BABY AND WANT TO GET COVERAGE FOR THE BABY WHAT FORM IS NEEDED

WHAT IS THE INFANT QUESTIONNAIRE?

200

THIS ONE WILL BE THERE IS AN AGENT FORGET SOMETHING

WHAT IS THE I SAW QUESTIONNAIRE?

200

ALCHOL USE, DRUG, ARREST QUESTIONNAIRES NEED TO BE FILLED OUT WHEN CLIENT STATES YES TO QUESTION ON APPLICATION

WHAT IS 18?

300

C DEVELOPS ONLY IN INDIVIDUALS THAT ARE INFECTED WITH B  WHICH FORM IS NEEDED?

WHAT IS HEPATITIS HISTORY QUESTIONNAIRE?

300

IF A CLIENT STATES THEY ARE A ________ INSTRUCTOR, THE SKY DIVING QUESTIONNAIRE NEEDS TO BE FILLED OUT

WHAT IS SKY DIVING?

300

IF A CLIENT HAS THIS DUODENAL WHICH FORM IS NEEDED

WHAT IS UCLER QUESTIONNAIRE?

300

 TAKING MEDICATION FOR BLOOD PRESSURE  THIS IS NEEDED

WHAT IS HIGH BLOOD PRESSURE QUESTIONNAIRE?

300

IF CLIENT IS CURRENTLY ACTIVE DUTY MILITARY  WHAT COVERAGE DO WE WANT TO MAKE THEM AWARE OF 

WHAT IS SERVICEMEN'S GROUP LIFE INSURANCE (SGLI)?

400

IN EAPP HOW MANY QUESTIONNAIRES ARE THERE UNDER TAB FOR QUESTIONNAIRES

WHAT IS 34?

400

REASON TO FILL OUT RESIDENCY ADDENDUM THE CLIENT IS _________

WHAT IS AN ALIEN?

400

IF A CLIENT STATES THEY HAVE CROHN'S DISEASE WHICH IS NEEDED

WHAT IS DIGESTIVE TRACT QUESTIONNAIRE?

400

WHEN AGENTS NORMALLY FILL OUT A DRIVER'S LICENSE QUESTIONNAIRE IS BECAUSE CLIENT

WHAT IS LOST WALLET?

400

DRUG QUESTIONNAIRE INFORMATION NEEDED

WHAT IS ARRESTED FOR?

500

CLIENT STATES THEY ARE SKIN DIVERS ONLY, ON THE SCUBA DIVING QUESTIONNAIRE WHAT BOX NEEDS TO BE CHECKED

WHAT IS I SKIN DIVE ONLY?

500

A CLIENT STATES THEY HAVE ANEXITY THE __________ QUESTIONNAIRE IS NEEDED

WHAT IS DEPRESSION?

500

IF A PERSON HAS DUI OR ARREST RECORD THE QUESTIONNAIRE NEEDED IS CALLED

WHAT IS ALCHOL USE QUESTIONNAIRE?

500

THE USE OF A CPAP MACHINE THIS FORM IS NEEDED

WHAT IS SLEEP APNEA QUESTIONNAIRE?

500

WHEN FILLING OUT A SEIZURE QUESTIONNAIRE, IF A CLIENT HAS NOT HAD A SEIZURE IN THREE YEARS, THE APPROVAL WILL BE 

WHAT IS STANDARD?

600

THE MINIMUM AMOUNT OF RACING TIMES A MONTH NOT TO FILL OUT THE RACING QUESTIONNAIRE

WHAT IS ONE?

600

IN RESPIRATORY QUESTIONNAIRE THESE ARE THE MAIN ITEMS ASTHMA, ALLERGIES, _________, EMPHYSEMA, PNEUMONIA, AND OTHER

WHAT IS BRONCHITIS?

600

CLIENT STATES HAVE GLOMERULONEPHRITIS NAME THAT FORM

WHAT IS KIDNEY QUESTIONNAIRE

600

MOUNJARO IS USED FOR WEIGHT LOSS BUT WHAT QUESTIONNAIRE IS NEEDED

WHAT IS THE DIABETIC QUESTIONNAIRE?

600

A CLIENT STATES THAT THEY WERE ON PAROLE WHAT TYPE OF QUESTIONNAIRE PULLS UP

WHAT IS AN ARREST QUESTIONNAIRE?

700

IF A CLIENT HAS HAD A HEART ATTACK A HEART/CIRCULATORY QUESTIONNAIRE NEEDS TO BE FILLOUT, HOW LONG DOES A CLIENT HAVE TO WAIT TO GET COVERAGE?

WHAT IS 6 MONTH?

700

IN THE CANCER/TUMOR QUESTIONNAIRE THERE ARE THREE TYPES OF SKIN CANCER WHICH ARE BASAL, SQUAMOUS, AND ____________

WHAT IS MELANOMA?

700

IF A CLIENT STATES THEY FLY PLANES FOR THEIR CAREER.  

WHAT IS AVIATION QUESTIONNAIRE?

700

ORAL SPECIMAN REFERS TO THIS TYPE OF PRESENTATION

WHAT IS ZOOM?

700

IN THE PANCREATITIS QUESTIONNAIRE HAS A QUESTION HAVE YOU BEEN DIAGNOSED OR TREATED FOR 

WHAT IS DIABETES?