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This document is used to collect the personal and medical history of individuals registering for various wellness programs at the University of Miami, ensuring a safe participation in fitness activities.
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How to fill out WELLNESS ENRICHMENT SUITE MEDICAL HISTORY FORM

01
Start with personal information: Fill in your full name, date of birth, and contact information.
02
Provide emergency contact details: Include the name and phone number of someone to contact in case of an emergency.
03
List medical history: Record any past illnesses, surgeries, or chronic conditions you have experienced.
04
Include current medications: Write down any medications you are currently taking, including dosages and frequency.
05
Document allergies: Note any known allergies to medications, foods, or environmental factors.
06
Fill out family medical history: Indicate any hereditary conditions present in your family, such as diabetes or heart disease.
07
Answer lifestyle questions: Provide information about your diet, exercise habits, and any substance use.
08
Review your information: Double-check all entries for accuracy and completeness before submission.
09
Sign and date the form: Confirm that all information is correct by signing and dating the form.

Who needs WELLNESS ENRICHMENT SUITE MEDICAL HISTORY FORM?

01
Individuals seeking wellness assessments or services.
02
New clients at the Wellness Enrichment Suite.
03
Anyone who has had a significant change in health or medication.
04
Patients referred by healthcare providers for wellness programs.
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The WELLNESS ENRICHMENT SUITE MEDICAL HISTORY FORM is a document used to collect an individual's medical history and background information to tailor wellness programs and services.
Individuals participating in wellness programs or seeking specific medical assessments related to their health and wellness are typically required to file the WELLNESS ENRICHMENT SUITE MEDICAL HISTORY FORM.
To fill out the WELLNESS ENRICHMENT SUITE MEDICAL HISTORY FORM, individuals should provide accurate personal information, including medical history, current medications, allergies, and any relevant medical conditions as prompted by the form.
The purpose of the WELLNESS ENRICHMENT SUITE MEDICAL HISTORY FORM is to gather essential health information that assists healthcare providers in developing personalized wellness plans and ensuring safe program participation.
The information that must be reported includes personal identification details, medical history, current medications, past surgeries, allergies, and any other relevant health issues that might impact wellness services.
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Relevant keywords

medical history fitness program participant registration health assessment wellness center University of Miami exercise safety medical clearance cardiovascular health fitness assessment

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