A medical questionnaire — a form filled out at clinics or hospitals asking about medical history, current symptoms, allergies, etc. (also written 問診表).
初診の際に問診票に記入してください。
Please fill out the medical questionnaire at your first visit.
問診票にアレルギーの有無を詳しく書いてください。
Please write details about any allergies on the questionnaire.
最近は病院の問診票をオンラインで提出できるところが増えた。
Recently more hospitals allow submitting the medical questionnaire online.