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Sports Medicine Questionnaire Mobile App

The Sports Medicine Questionnaire mobile app records: Patient Information, Medications and Supplements, Medication/Food Allergies, Equipment/Facilities Available, Current Physical Activities and Sports You Participate. A GoCanvas account can be specified as being HIPAA compliant. By turning on HIPAA compliance, a number of features that most of users find desirable will be disabled to meet HIPAA Standards. Individual apps in the GoCanvas Application Store can easily be made HIPAA Compliant. If you have any questions or need assistance you can contact our Sales team to help you at Sales@GoCanvas.com. If you would like to enable HIPAA on your GoCanvas account please follow the instructions below: 1. Log onto your Account 2. Click “My Account” in the top right corner of the screen 3. Click “Customize” on the left 4. The third option is for HIPAA Compliance, click “Edit” on the right 5. Check the “Enable HIPAA Compliance” box and select “Save”

  • Lendlease
  • The Cooperative
  • PG&E
  • Toys R Us
  • Red Bull
  • Mirvac

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Take a peek inside the Sports Medicine Questionnaire Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Name

  • Ico multiline

    Address

  • Ico date

    Date of Birth

  • Ico textbox

    Health Card #

  • Ico textbox

    Email

  • Ico textbox

    Home Phone

  • Ico textbox

    Cell Phone

  • Ico textbox

    Contact Person

  • Ico textbox

    Family Doctor

  • Ico multiline

    Address

  • Ico textbox

    Occupation

  • Ico textbox

    Business Phone

  • Ico textbox

    Contact Phone

  • Ico textbox

    Who referred?

  • Ico textbox

    Medication or Supplement Name

  • Ico textbox

    Dosage,

  • Ico textbox

    Frequency

  • Ico date

    Date Started

  • Ico statictext

    Medications and Supplements (list all prescription medications and supplements)

  • Ico statictext

    BRING ALL MEDICINES TO APPOINTMENT

  • Ico dropdown

    Do you have any Medicine or Food allergies?

  • Ico multiline

    If yes, Please list:

  • Ico dropdown

    Do you engage in regular physical activity?

  • Ico dropdown

    Do you have access to a fitness gym?

  • Ico checkbox

    Commercial

  • Ico checkbox

    Private studio

  • Ico checkbox

    Home

  • Ico checkbox

    Condominium

  • ...and More!

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