Home
Forms Library
UPDATE HISTORY FORM2 - Foothill Family Clinic Draper

UPDATE HISTORY FORM2 - Foothill Family Clinic Draper 2025

UPDATE HISTORY FORM2 - Foothill Family Clinic Draper Preview on Page 1

See details

4.8 out of 5

89 votes

The document is a Patient History Update Form designed to collect comprehensive information about a patient's current medications, allergies, social habits, past medical history, family medical history, and review of systems. It includes sections for listing prescription and over-the-counter medications, documenting any allergies and their reactions, detailing social habits such as tobacco and alcohol use, noting recent surgeries or hospitalizations, and assessing various health systems.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out UPDATE HISTORY FORM2 - Foothill Family Clinic Draper

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by entering your name and birthdate at the top of the form. This information is essential for identifying your medical records.
In the 'Prescription Medications' section, list all medications you are currently taking, including over-the-counter drugs and supplements. Fill in the medication name, strength, frequency, and reason for each medication.
Indicate if a refill is needed for each medication by checking 'Y' or 'N'.
Next, document any medication allergies you have along with their reactions in the designated fields.
Complete the social history section by answering questions about tobacco, alcohol, and caffeine use. Be sure to specify types and amounts where applicable.
Provide details on any recent surgeries or hospitalizations under past medical history. Include dates and locations.
Fill out family history by marking any relevant conditions that have affected family members since your last physical.
Finally, review systems by circling any health issues that apply to you from the provided list.

Start filling out your UPDATE HISTORY FORM2 today using our platform for free!

See more UPDATE HISTORY FORM2 - Foothill Family Clinic Draper versions

We've got more versions of the UPDATE HISTORY FORM2 - Foothill Family Clinic Draper form. Select the right UPDATE HISTORY FORM2 - Foothill Family Clinic Draper version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (89 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I sign my UPDATE HISTORY FORM2 - Foothill Family Clinic Draper electronically?

As outlined by eSignature laws, forms signed digitally have the same validity as those approved with pen and paper. You can eSign almost any business and personal documentation. Four types of paperwork still require wet signatures only - wills and testamentary trusts, court orders and other court papers, state statutes governing divorce, adoption, or other family law, and notice of cancellation of utility services. If you follow the regulations and utilize a trustworthy and compliant software solution, like DocHub, you can eSign your UPDATE HISTORY FORM2 - Foothill Family Clinic Draper without printing it.

How do you edit UPDATE HISTORY FORM2 - Foothill Family Clinic Draper from Google Drive?

If you store your paperwork in Google Drive, there is no need to download your UPDATE HISTORY FORM2 - Foothill Family Clinic Draper on the computer and upload it back to our editor. A significantly easier way is to set up a browser extension developed by DocHub to simplify this flow. The extension allows editing PDFs right in your internet browser. Alternatively, you may integrate your DocHub and Gmail accounts for more efficient editing.