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Click ‘Get Form’ to open the Health History Adolescent (13-18yo) Form in our editor.
Begin by entering your name, grade, date of birth, and today’s date at the top of the form. This information is essential for identifying your health history.
In the 'Drug Allergies' section, list any allergies you have along with the type of reaction experienced. If none, simply indicate that there are no drug allergies.
For 'Current Medications', specify any medications you are taking, including over-the-counter and herbal products. Fill in the name, dose, and frequency for each medication listed.
Review the section on past health issues. Circle any conditions you have or have had from the provided list to ensure comprehensive health documentation.
Document any hospitalizations or surgeries by providing dates and reasons for each visit or procedure in the designated area.
Complete family medical history by indicating if relatives have had specific health concerns. This helps provide context for your own health risks.
Fill out personal details such as parent names, household members, work status, hobbies, and substance use history to give a complete picture of your lifestyle.
If applicable, females should provide menstrual history details including age started and cycle regularity in the specified section.
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