Medical History Questionnaire - Concourse Optometry 2026

1. Click ‘Get Form’ to open the Medical History Questionnaire in the editor.
2. Begin by entering your name at the top of the form. This personalizes your questionnaire and ensures accurate record-keeping.
3. Proceed to the allergies section. Indicate if you have any allergies to medications by selecting 'yes' or 'no'. If applicable, provide details in the space provided.
4. List all medications you are currently taking, including over-the-counter drugs and home remedies. Be thorough to ensure your healthcare provider has complete information.
5. In the injuries and surgeries section, detail any major medical events you've experienced. This helps in understanding your medical history better.
6. Complete the family history section by noting any relevant conditions that may affect your health assessments.
7. Fill out the social history section, indicating preferences for discussing this information directly with your doctor if desired.
8. Review all sections carefully before submitting to ensure accuracy and completeness of your medical history.

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