Cardiac Rehab Patient Forms

Below are links to five online surveys, as well as a form for medications, that we would like you to complete prior to your first exercise session. We estimate the surveys should take about 30 minutes to complete. Please feel free to call the rehab center at 949-364-7755 should you have any questions.

• Risk Factor Questionnaire
• PHQ9 Questionnaire
• Dartmouth COOP Questionnaire
• Fall Risk Questionnaire
• Sleep Apnea Questionnaire
• Medication List