Rheumatology Specialists of Connecticut

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Rheumatology Specialists of Connecticut

Since your last visit, have you / Desde su última visita, ha:
If yes, please specify
En caso sí, especificar
Had any illnesses or new diagnosis? Había enfermedades o cualquier nuevo diagnóstico?
Been seen by any other doctors? Sido vist
Had any x-rays, labs, and/or other procedures? Tenido rayos-x, laboratorios, y / o otros procedimientos?
Any new allergies or reactions to medicines? Cualquier nuevo alergias o reacciones a los medicamentos?
Any relatives with new diagnosis of major illnesses (parents, grandparents, children, siblings, etc.)? Cualquier familiares con nuevo diagnóstico de las principales enfermedades (padres, abuelos, hijos, hermanos, etc)?
Any changes in your social situation (work, residence, relationships, smoking, alcohol use, etc.)? Cualquier cambio en su situación social (trabajo, residencia, relaciones, el consumo de tabaco, alcohol, etc)?
Had any medication started, stopped or dosage changed? Algún medicamento había iniciado, detenido o dosis cambiado? On the back of this sheet, please state: 1) name of medicine; 2)whether new, stopped, or had dose changed; 3) person who made this change; 4) reason this change was made.
How do you feel today compared with your last visit here? / ¿Cómo te sientes hoy en día en comparación con su última visita aquí?
Please rate the following items using this scale / Por favor califique los siguientes temas utilizando esta escala:
N = new problem / nuevo problema 0 = problem not present today / problema que no se presente hoy 1 = much better / mucho major
2 = better / major 3 = same / mismo 4 = worse / peor 5 = much worse / mucho peor

Rheumatology Specialists of Connecticut

Please list any medicines which are new, stopped or have a different dose since your last visit:
Por favor, cualquier lista de medicamentos que son nuevos, o que han dejado una dosis diferente desde su última visita:

We’re closing Our Fragmington Office!

We are closing our Farmington Office location and will see all appointments at the Manchester office starting 1 September, 2025.

All Farmington appointments will remain at current scheduled date and time, but the location will change to our Manchester Office.