Get the free Medical History and Physical Examination Form

Student Health Center Box 7188 Davidson, N.C. 280357188 Phone: 7048942300 FAX: 7048942615 Medical History and Physical Examination Form TO ALL NEW STUDENTS ENTERING DAVIDSON COLLEGE Please complete

How to fill out medical history and physical

To fill out a medical history and physical form, follow these step-by-step instructions:

1. Start by providing your personal information, including your full name, date of birth, gender, and contact details.
2. Next, list any current medications you are taking, including the dosage and frequency.
3. Include information about any allergies you have, specifying the type of allergy and reactions you may experience.
4. Provide a detailed medical history including any prior illnesses, surgeries, or hospitalizations you have had.
5. Mention any chronic conditions or ongoing health issues you are currently being treated for, such as diabetes, asthma, or hypertension.
6. Don't forget to disclose any family history of diseases or genetic conditions that may be relevant to your health.
7. Provide information about your lifestyle habits, such as smoking, alcohol consumption, exercise routine, and diet.
8. Mention any mental health conditions you have been diagnosed with or are currently seeking treatment for.
9. Lastly, sign and date the form to indicate that the information provided is accurate to the best of your knowledge.

Medical history and physicals are necessary for individuals of various backgrounds and situations. Some common examples include:

1. New patients visiting a primary care physician or specialist for the first time typically need to fill out a medical history and physical form. This enables the healthcare provider to gather crucial information about the patient's health before providing appropriate care.
2. Individuals undergoing pre-employment screenings or physical examinations as part of their job requirements often need to fill out a medical history and physical form. This helps employers assess the candidate's suitability and potential health risks in a work environment.
3. Athletes participating in sports programs or competitive events usually require a medical history and physical to ensure they are physically fit and free from any conditions that may impact performance or safety.
4. Individuals applying for life insurance or certain types of insurance policies may be asked to complete a medical history and physical form, which helps the insurance company assess the level of risk associated with insuring the individual.

In summary, filling out a medical history and physical requires providing comprehensive and accurate information about your health, medical background, and any pertinent details. This process is essential for various individuals seeking medical care, undergoing screenings, participating in sports, or applying for insurance.

For pdfFiller’s FAQs

What is medical history and physical?

Medical history and physical is a document that details a person's past medical conditions, surgeries, medications, and other relevant health information, along with a physical examination.

Who is required to file medical history and physical?

Medical history and physical is typically required to be filed by individuals seeking medical treatment, undergoing surgery, or applying for certain jobs that require a health evaluation.

How to fill out medical history and physical?

Medical history and physical forms can be filled out by providing accurate and detailed information about past medical conditions, surgeries, medications, allergies, family history, and undergoing a physical examination by a healthcare provider.

What is the purpose of medical history and physical?

The purpose of medical history and physical is to provide healthcare providers with a comprehensive overview of a person's health status, which helps in making accurate diagnoses, determining treatment plans, and monitoring overall health.

What information must be reported on medical history and physical?

Information that must be reported on medical history and physical includes past medical conditions, surgeries, medications, allergies, family history of certain diseases, current symptoms, and results of the physical examination.

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