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1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name and date of birth in the designated fields. Ensure accuracy for proper identification.
3. Select the gender of the patient by checking either 'M' or 'F'.
4. Fill out the section regarding who is completing the form, including their relationship to the patient and occupation.
5. Provide details about the preferred pharmacy, previous primary care provider, and any relevant maternal and birth history if applicable.
6. List any allergies, medications, immunizations, and medical history as prompted in each section. Be thorough to ensure comprehensive care.
7. Complete family history and social history sections by providing information about family health conditions and household dynamics.
8. Review all entries for accuracy before submitting your completed form through our platform.

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