Hi Ashley,
I use a simple one page form and give it to the Medical Assistants in the practice. They ask the patient if they would be willing to complete it and point out which “doctor” they are evaluating. I have had great success with this method.
~Laurel
I have it saved as a PDF and Publisher file (attached). Hopefully, you can use these. I think having the photo of the resident that they are evaluating is important for the patient to see.
~Laurel