Endocrine Health Self-Assessment


Are You Ready to Embark on Your Wellness Journey with Dr. Maria Isabel?

Before your first consultation, we invite you to reflect on your health journey. This questionnaire is designed to help you articulate your current health status, goals, and readiness for positive change. Your responses will provide valuable insights, enabling a more personalized and effective approach to your care.

Take a moment to consider your endocrine health, nutritional habits, and goals and write down your answers. Keep the answers handy before your first telehealth consultation.

Health History

  • Have you been diagnosed with any endocrine-related conditions such as diabetes, thyroid disorders, or hormonal imbalances?
  • Are you currently on any medications related to endocrine health?

Current health concerns

  • What specific symptoms or health concerns are you currently experiencing?
  • Have you experienced any recent changes in weight, energy levels, or overall well-being?

Previous medical history

  • Have you previously sought medical attention for endocrine or hormonal issues? If yes, please provide a brief history.

Nutritional habits

  • How would you describe your current nutritional habits? Are there specific dietary challenges you are facing?

Endocrine health goals

  • What are your primary health goals related to endocrine or hormonal well-being?
  • Are there specific outcomes you are hoping to achieve through consultation with Dr. Esparza?

Motivation for change

  • Have you previously sought medical attention for endocrine or hormonal issues? If yes, please provide a brief history.

Readiness for virtual consultation

  • Are you comfortable with and have access to the technology required for virtual consultations?
  • How do you feel about the prospect of receiving medical care through virtual channels?

Commitment to follow-up care

  • Can you commit to regular follow-up appointments and the implementation of recommended treatment plans?
  • Are you willing to actively participate in your health management?

Additional information

  • Is there any additional information about your health, lifestyle, or preferences that you believe is important for me to know?

Note: This questionnaire is a self-assessment tool and not a substitute for professional medical advice. Answers to these questions will help me understand your health context and needs better.