Pulmonary, Critical Care and Sleep MedicineOhio State 2026

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2. Begin by entering your personal information in the designated fields, including your name, age, and date of birth. This foundational data is crucial for your evaluation.
3. Proceed to the symptoms section. For each symptom listed, select 'Yes' or 'No' based on your experience. This helps the medical team understand your current health status.
4. In the medical history section, check any illnesses you have been treated for and list any surgeries or hospitalizations along with their dates. This provides a comprehensive view of your health background.
5. Fill out the medications section by listing all prescribed and over-the-counter medicines you are currently using, including dosages and frequency. Indicate if you have trouble affording these medications.
6. Complete the family history and social history sections by providing relevant details about your family's medical background and your lifestyle habits.
7. Review all entered information for accuracy before submitting. Once satisfied, save or submit the form directly through our platform.

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