I don't think you data model is 'right'. when ever you see columns such as 'comments' ' additioanl comments; or column1,colu,mn2...columnx is a striong indic\ation the design is flaky
TBH I found your form confusiing, took me a whiel to work out how it worked.
As to the data model
Imnto cerain you appreciate the purpose behind an autonumber column. Its prime roel is an easy way of guaranteeing a unique value (required for a primary key), however you'd use an autonumber column if:-
..there's no obvious column(s) in the data which could be unique
..that/those other obvious column(s) are likelyu to change making them problematic as a PK
..the obvious columns would be overly complex.
other than that use pre existign columns instead of substituting with an autonumber column.
...presumably a visit date is unique in itself, a patient ID should be unique enough (although if you don't know the patient ID at the time the row is created then that could be good reason to use an autonumber column
you have different visits define as per the form , yet only one table storing the dtaa. if the design was normalised I'd expect to see, say 6 tables
1 that stores the common stuff as part of any visit
1 sub table for each of the other 5 visit types.
Incidentally Id' be tempted to have a comments tabel hanigng off the common visit table.
If visit 5 is essentially a subset of visit 2, then hang it off visit 2 as a sub table
consider using a tabbed dialog to display the relevant data
tab 1 say has all visit 1 rowes for that patient, and so on...
I'd rather be riding on the Tiger 800 or the Norton