Medical History Form - Planned Parenthood - plannedparenthood 2025

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The document is a comprehensive medical history questionnaire designed for patients visiting Planned Parenthood of New York City. It collects personal information, including demographics, medical and medication history, allergies, surgical history, family health background, social habits (such as diet and substance use), sexual history, gynecological history, birth control usage, and obstetric history. The purpose is to gather detailed health information to ensure appropriate care while maintaining confidentiality.

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2014	4.9 Satisfied (47 Votes)

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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.

Can my parents see if I went to Planned Parenthood?

Our health centers provide confidential services, so your parents/guardians do not have to know that you came for a visit. In some cases, we are required by law to report certain issues or situations to agencies that can help you. For your safety, some things cannot stay confidential.

How can I find out my family medical history?

To get the complete picture, use family gatherings as a time to talk about health history. If possible, look at death certificates and family medical records. Collect information about your parents, sisters, brothers, half-sisters, half-brothers, children, grandparents, aunts, uncles, nieces, and nephews.

What documents do I need for Planned Parenthood?

What to bring: Bring your photo ID, insurance card, copay, and policyholder information.

Can I see my parents medical history?

To share health records with family, patients typically need to sign a HIPAA disclosure form that identifies what records to share and the person who can receive them.

Can you access your parents medical records?

To receive a copy of your loved ones health records as a Personal Representative, you typically must ask for it in writing. In some cases, the hospital or doctors office may have a form to request the records. Even with the legal right, however, this can prove to be a challenging process.

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Can people look up your medical history?

Only you or your personal representative has the right to access your records. A health care provider or health plan may send copies of your records to another provider or health plan only as needed for treatment or payment or with your permission.

Do my parents have access to my MyChart?

You can request proxy access to your family members account or give access to your account to a family member or caregiver. If you have proxy access to someones account, you can see their healthcare information, as well as your own, from within the same MyChart account.

Does Planned Parenthood keep medical records?

We are required by law to keep the information and records we have about your health, health status, and health services you receive at our office private and to provide you with this notice about our privacy practices.

Medical History Form - Planned Parenthood - plannedparenthood 2025

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Can my parents see if I went to Planned Parenthood?

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What documents do I need for Planned Parenthood?

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Can you access your parents medical records?

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Can people look up your medical history?

Do my parents have access to my MyChart?

Does Planned Parenthood keep medical records?

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