Swedish Urology Group Patient History FormFemale 2025

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The document is a Patient History Form for female patients at the Swedish Urology Group. It collects confidential information regarding the patient's current medical issues, past medical history, medications, allergies, family medical history, and social habits. The form includes specific questions about urologic symptoms and general health to assist in diagnosing and treating the patient.

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Click ‘Get Form’ to open the Swedish Urology Group Patient History FormFemale in the editor.
Begin by entering your personal information at the top of the form, including your name, today's date, date of birth, age, and social security number.
Indicate if you were referred by another physician and provide their name and phone number if applicable.
In the 'CURRENT PROBLEM' section, describe your main symptoms in detail. Be sure to include when you first noticed them and any relevant history.
Fill out the 'PAST MEDICAL HISTORY' section by listing any illnesses that required treatment or hospitalization, along with current medications.
Complete the 'FAMILY MEDICAL HISTORY' section by noting any major illnesses in family members.
Provide details in the 'SOCIAL HISTORY' section regarding your occupation, marital status, smoking habits, alcohol consumption, and recreational drug use.
Finally, check or circle any relevant symptoms listed under 'Female Urologic Symptoms/History' to ensure comprehensive documentation.

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