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Medical History Questionnaire - Concourse Optometry 2026
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- Click ‘Get Form’ to open the Medical History Questionnaire in the editor.
- Begin by answering the allergy question. If you have allergies to medications, select 'yes' and provide details in the space provided.
- List any medications you are currently taking, including over-the-counter drugs and home remedies, in the designated area.
- Document any major injuries, surgeries, or hospitalizations you've experienced in the next section.
- Indicate if you have had any eye conditions such as glaucoma or cataracts by checking 'yes' or 'no' and providing explanations where necessary.
- Complete the family history section by noting any relevant conditions that run in your family, along with their relationship to you.
- Fill out your social history, including driving habits and substance use. You can choose to discuss this information directly with your doctor if preferred.
- Review the systems section carefully. Mark 'yes', 'no', or '?' for each health issue listed and provide additional explanations if needed.
- Finally, ensure all sections are completed before saving your document for submission.
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