Adult medical history 2025

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4.8 out of 5

204 votes

The document is an Adult Medical History Form designed to collect comprehensive personal, medical, and social information from patients. It includes sections for personal information, present health concerns, medications, allergies, personal and family medical history, social habits (including substance use), sexual health, immunizations, and a review of symptoms. The form aims to assist clinicians in understanding the patient's medical background and current health status.

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Click ‘Get Form’ to open the adult medical history document in the editor.
Begin by filling out your personal information, including your preferred name, contact details, and emergency contact. This section is crucial for ensuring effective communication with your healthcare provider.
Move on to the 'Present Health Concerns' section. Clearly outline any current health issues you are experiencing. This helps your clinician understand your immediate needs.
In the 'Medications' section, list all prescription and non-prescription medications you take, along with their dosages. If you have allergies, make sure to note them in the designated area.
Complete the 'Personal Medical History' and 'Family History' sections by checking relevant boxes and providing additional details as necessary. This information is vital for assessing hereditary health risks.
Finally, review all entries for accuracy before saving or submitting your completed form. Our platform allows you to easily edit any mistakes.

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See more adult medical history versions

We've got more versions of the adult medical history form. Select the right adult medical history version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2023	4.8 Satisfied (35 Votes)
2022	4.3 Satisfied (46 Votes)
2021	4.8 Satisfied (67 Votes)
2021	4.8 Satisfied (37 Votes)
2021	4.5 Satisfied (34 Votes)
2021	4.8 Satisfied (155 Votes)
2020	4.8 Satisfied (161 Votes)
2020	4.8 Satisfied (135 Votes)
2020	4.8 Satisfied (53 Votes)
2020	4.7 Satisfied (43 Votes)
2020	4.8 Satisfied (133 Votes)
2020	4.4 Satisfied (124 Votes)
2019	4.4 Satisfied (24 Votes)
2019	4.3 Satisfied (31 Votes)
2018	4.5 Satisfied (50 Votes)

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What is an example of HPI?

What information goes into a PHR? Your healthcare professionals names and phone numbers. Allergies, including medicine allergies. Your medicines, including how much you take and how often. Illnesses and surgeries youve had and when. Procedures, such as mammograms and colonoscopies, youve had and when.

What are examples of a patients history?

HPI notes are often used to inform emergency and admission notes so they must be able to give a complete picture of the patients situation in a few short sentences. Example: Sudden onset of sharp chest pain, radiating to the left arm and jaw. Continuous for 2 hours and no relief with rest or antacids.

What does a medical history include?

Please list any past medical history below with date of onset or diagnosis. Examples include asthma, diabetes, depression, anxiety, drug or alcohol dependency, high blood pressure, thyroid disease, autoimmune disease, chronic pain, gynecologic disorder. Have you ever had surgery?

What shows up in medical history?

A health record (also known as a medical record) is a written account of a persons health history. It includes medications, treatments, tests, immunizations, and notes from visits to a health care provider.

What are the six components of medical history?

A comprehensive history intake includes the patients medical history, past surgical history, family medical history, social history, allergies, and medications.