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See more fillable medical history form versions

We've got more versions of the fillable medical history form form. Select the right fillable medical history form version from the list and start editing it straight away!
Versions Form popularity Fillable & printable
2011 4.8 Satisfied (301 Votes)
2009 4.9 Satisfied (52 Votes)
2005 4.7 Satisfied (35 Votes)
2010 4.8 Satisfied (121 Votes)
2001 4.8 Satisfied (121 Votes)
2008 4.8 Satisfied (81 Votes)
1997 4.8 Satisfied (30 Votes)
2015 4.9 Satisfied (473 Votes)
2011 3.9 Satisfied (28 Votes)
2016 4.8 Satisfied (80 Votes)
2006 4.8 Satisfied (292 Votes)
2014 4.8 Satisfied (62 Votes)
2014 4.8 Satisfied (146 Votes)
2011 4.8 Satisfied (171 Votes)
2009 4 Satisfied (29 Votes)
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At its simplest, your record should include: Your name, birth date and blood type. Information about your allergies, including drug and food allergies; details about chronic conditions you have. A list of all the medications you use, the dosages and how long you've been taking them. The dates of your doctor's visits.
A medical history form is a questionnaire used by health care providers to collect information about the patient's medical history during a medical or physical examination.
At its simplest, your record should include: Your name, birth date and blood type. Information about your allergies, including drug and food allergies; details about chronic conditions you have. A list of all the medications you use, the dosages and how long you've been taking them. The dates of your doctor's visits.
A medical record is a systematic documentation of a patient's medical history and care. It usually contains the patient's health information (PHI) which includes identification information, health history, medical examination findings and billing information.
What information should be included on a medical history form? Medications you are currently taking or have recently stopped taking. Allergies (food, medication, environmental, products, etc.) Previous injuries. Recent illnesses. Past hospitalizations (reason, dates, duration, treatment)
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According to AMN Healthcare Education Services, the health history includes: the patient's medical complaint, present state of health, past health record, current lifestyle, psychosocial status and family history.
Basics of history taking Chief concern (CC) History of present illness (HPI) Past medical history (PMH) including preexisting illnesses, medication history, and allergies. Family history (FH) Social history (SH) Review of systems (ROS)
A record of information about a person's health. A personal medical history may include information about allergies, illnesses, surgeries, immunizations, and results of physical exams and tests. It may also include information about medicines taken and health habits, such as diet and exercise.
A medical record is a systematic documentation of a patient's medical history and care. It usually contains the patient's health information (PHI) which includes identification information, health history, medical examination findings and billing information.
In general, a medical history includes an inquiry into the patient's medical history, past surgical history, family medical history, social history, allergies, and medications the patient is taking or may have recently stopped taking.

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