Get the free ADULT Medical Questionnaire - Emory University Department of - genetics emory

Department of Human Genetics Division of Medical Genetics www.genetics.emory.edu NAME: ADDRESS: ADULT GENETICS PATIENT QUESTIONNAIRE PHONE: BIRTHDATE: Instructions: Please answer all questions to

How to fill out adult medical questionnaire

How to fill out an adult medical questionnaire:

1. Start by reading through the entire questionnaire to familiarize yourself with the sections and types of information needed.
2. Gather any necessary documents or information that may be relevant to the questionnaire, such as previous medical records or a list of current medications.
3. Begin with the personal information section, filling in your full name, date of birth, address, and contact information.
4. Move on to the medical history section, where you will be asked about any past or current medical conditions, surgeries, allergies, and medications. Provide as much detail as possible, including dates and any relevant medical professionals.
5. Next, fill out the section for family medical history. This will require information about the health conditions of your immediate family members, such as parents, siblings, and children.
6. Proceed to the lifestyle and habits section, where you may be asked about your diet, exercise routine, smoking or alcohol consumption, and any other relevant lifestyle factors.
7. Complete the section for any current symptoms or concerns you may have, providing details about the duration, severity, and any specific triggers or patterns.
8. Finally, review and double-check all your answers to ensure accuracy and completeness before submitting the questionnaire.

Who needs an adult medical questionnaire:

1. Individuals who are seeking medical care or treatment, either for a specific condition or as part of routine check-ups, may be required to fill out an adult medical questionnaire.
2. Employers or organizations may request employees or members to complete a medical questionnaire for health insurance purposes or to assess any potential health risks or accommodations needed.
3. Individuals participating in certain activities or programs, such as sports teams, clinical trials, or travel abroad, may be required to complete a medical questionnaire to ensure they are physically fit and able to participate safely.

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What is adult medical questionnaire?

The adult medical questionnaire is a form used to gather information about a person's medical history and current health status.

Who is required to file adult medical questionnaire?

Adults who are undergoing medical evaluations or examinations are typically required to fill out an adult medical questionnaire.

How to fill out adult medical questionnaire?

To fill out an adult medical questionnaire, individuals should provide accurate information about their medical history, current medications, allergies, and any existing medical conditions.

What is the purpose of adult medical questionnaire?

The purpose of the adult medical questionnaire is to help healthcare providers assess a person's health status, identify potential risks or concerns, and ensure proper medical care and treatment.

What information must be reported on adult medical questionnaire?

Information such as medical history, current medications, allergies, existing medical conditions, and lifestyle habits should be reported on the adult medical questionnaire.