Get the free Physical Examination Form - clarku

A form used by Clark University Health Services to collect medical history and examination details for applicants, including information on past medical problems, medications, allergies, and physical

How to fill out physical examination form

How to fill out Physical Examination Form

1. Gather personal information: Enter your full name, date of birth, and contact information.
2. Provide medical history: List any past illnesses, surgeries, or ongoing medical conditions.
3. Fill in family medical history: Include relevant health issues of immediate family members.
4. Complete vaccination records: Document any vaccinations received and their dates.
5. Record current medications: List any medications you are currently taking with dosages.
6. Answer lifestyle questions: Provide details on exercise, diet, and use of substances like tobacco or alcohol.
7. Review the form: Ensure all sections are filled out accurately and completely.
8. Sign and date the form: Confirm that the information is true to the best of your knowledge.

Who needs Physical Examination Form?

1. Individuals applying for sports participation.
2. Students entering a new school or program requiring health clearance.
3. People seeking employment that mandates a health check.
4. Patients needing a pre-operative assessment.
5. Any person seeking to participate in a physical activity or program that requires health verification.

People Also Ask about

What does a full physical exam include?

These stages - or techniques - are inspection, palpation, percussion, and auscultation. Much like putting together a puzzle, all of the parts of the assessment come together to create the bigger picture and allow you to provide the best possible care to your patients.

What are the 4 principles of physical examination?

Physical examination is the process of evaluating objective anatomic findings through the use of observation, palpation, percussion, and auscultation. The information obtained must be thoughtfully integrated with the patient's history and pathophysiology.

How to fill out a physical examination form?

Begin by entering your personal details in the designated fields at the top of the form. Next, provide information regarding any current medications and allergies. Finally, complete the evaluation of your health by filling out the sections regarding physical examination findings and other relevant medical history.

What are the 4 components of a physical exam?

Inspection (looking at the body) Palpation (feeling the body with fingers or hands) Auscultation (listening to sounds, usually with a stethoscope) Percussion (producing sounds, usually by tapping on specific areas of the body)

For pdfFiller’s FAQs

What is Physical Examination Form?

A Physical Examination Form is a document used to assess and record an individual's health status, typically completed by a healthcare provider after a physical health assessment.

Who is required to file Physical Examination Form?

Individuals such as students, athletes, or employees in certain jobs may be required to file a Physical Examination Form to ensure they meet health and fitness standards.

How to fill out Physical Examination Form?

To fill out a Physical Examination Form, individuals should provide personal information, medical history, and any existing conditions, and then have a healthcare professional complete the examination section.

What is the purpose of Physical Examination Form?

The purpose of the Physical Examination Form is to document an individual's overall health, identify any health issues, and confirm fitness for specific activities or employment.

What information must be reported on Physical Examination Form?

The form must report personal identification details, medical history, current medications, allergies, vital signs, and findings from the physical examination conducted by a healthcare professional.