Patient Medication History Form - UW Medicine - depts washington 2025

Get Form
harborview medical records fax number Preview on Page 1

Here's how it works

01. Edit your harborview medical records fax number 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 harborview medical records via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Patient Medication History Form - UW Medicine - depts washington with our platform

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name at the top of the form. This identifies your medication history.
  3. In the 'Allergies' section, list any substances you are allergic to, including drugs and foods. Indicate the type of reaction and check 'none' if applicable.
  4. For female patients, answer questions regarding pregnancy and breastfeeding by selecting 'Yes' or 'No'.
  5. Move to the 'Current Medications' section. Fill in details for prescription drugs, including their strength, directions for use, and who prescribed them. Check the box if taken only as needed.
  6. Repeat step 5 for over-the-counter medications and any herbs, vitamins, or minerals you take.
  7. Complete the staff-only section with your pharmacy name and ensure all information is accurate before submission.

Start using our platform today to easily complete your Patient Medication History Form online for free!

See more Patient Medication History Form - UW Medicine - depts washington versions

We've got more versions of the Patient Medication History Form - UW Medicine - depts washington form. Select the right Patient Medication History Form - UW Medicine - depts washington version from the list and start editing it straight away!
Versions Form popularity Fillable & printable
2007 4 Satisfied (35 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.
Contact us
UW Health MyChart users can complete a Release of Information request by logging in to their MyChart account. Click on Menu, scroll down to Resources and then select Request My Medical Records. These requests are submitted to the Medical Records Department automatically and will be forwarded.
Who do I contact to get my medical records? Hospitals and health service providers manage their own patient records. This means that to access your medical records, you will need to directly contact the hospital or health service provider where you were a patient.
Editors Note: Update July 15, 2020: In July 2020, Cigna Corporation and UW Medicine docHubed an agreement. The contract between Cigna and UW Medicine will no longer be terminated beginning Aug. 1, 2020.
If you do not contact us to cancel or reschedule, and you do not attend your appointment, you may be charged a $75 or $100 no-show fee. If you cancel without 24 hours notice, you may be charged a $50 late cancellation fee.
Options for requesting and transferring medical records Determining if we have the records you seek. Obtaining your medical records. Mail. UW Medicine Medical Records Department. 325 Ninth Avenue. Box 359738. Seattle, WA 98104. Phone. Fax. 206-744-9997. Email. uwmedroi@uw.edu. Give someone access to your medical record. Get help.
be ready to get more

Complete this form in 5 minutes or less

Get form

People also ask

If you have an activation code from your doctor Look for an activation code on your After Visit Summary or in an email or text message from your healthcare organization. Follow the instructions provided with your activation code to create your MyChart account. Go to MyChart. Enter your: Create a username and password.
If your provider has a designated medical records department, contact them directly. Provide any reference numbers, confirmations, or details you received when submitting your request. It will help your provider quickly locate your file.

uwmc medical records