Physician form 2025

1. Click ‘Get Form’ to open the Physician Summary Form in the editor.
2. Begin by entering the patient's last name, first name, and date of birth in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Select the patient's gender by checking either 'F' for female or 'M' for male.
4. In the Diagnosis section, indicate any mental illness or disabilities by checking the appropriate boxes and providing specific details.
5. List all treatments and medications. Use the back of the form if necessary to include additional medications, specifying type, frequency, drug name, dose, route, and frequency.
6. Fill in recent vital signs including temperature (T), pulse (P), respiration (R), and blood pressure (BP) along with their respective dates.
7. Indicate any known allergies or mark 'No known allergies'.
8. Complete sections on height, weight, continence status for bowel and bladder, and any special needs or additional comments.
9. Certify that all information is accurate by signing at the bottom of the form. Remember to print your name and address as well.

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