Download Our Medical History Form - Biofortis Clinical Research 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your initials, full name, and date of birth at the top of the form. Ensure all personal information is accurate.
3. Fill in your address, phone numbers, gender, race, and ethnicity. Use the checkboxes provided for gender and ethnicity selections.
4. Complete the emergency contact section by providing the name, relationship, address, and phone numbers of your emergency contact.
5. Proceed to the conditions section. For each condition listed, check 'Yes' or 'No' as appropriate and provide additional details such as start dates if applicable.
6. Continue filling out sections on medications, surgeries/hospitalizations, social history, family history, and any investigational studies you have participated in.
7. Review all entries for accuracy before saving or submitting your completed form.

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