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Plaza 2 1301 South Cliff Avenue, Suite 220 Sioux Falls SD 57105 (605) 3223790 Fax (605) 3223791 Name Today's Date Age Birthdate Date of last physical exam Are you presently under a physicians care
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How to fill out health history - Avera:

01
Start by gathering all relevant medical documents and information. This includes previous medical records, medication lists, and any recent test results.
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Begin filling out the form by providing personal information such as your name, date of birth, and contact information.
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Specify your current primary care physician or healthcare provider, as well as any specialists you may be seeing.
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Detail any existing medical conditions or diagnoses you have been given. Be as specific as possible, including the dates of diagnosis and any relevant treatments or medications.
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Include any past surgeries or hospitalizations, noting the dates and reasons for these procedures.
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Provide a comprehensive list of all medications you are currently taking, including the dosage and frequency.
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Specify any known allergies or adverse reactions to medications, foods, or other substances.
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Include a complete family medical history, noting any medical conditions or diseases that run in your family.
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Detail any previous or ongoing mental health conditions, including diagnoses, treatment plans, and medications.
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Indicate any relevant lifestyle choices or habits, such as smoking, alcohol consumption, or recreational drug use.

Who needs health history - Avera?

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Individuals who are new patients at Avera healthcare facilities or clinics.
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Patients seeking comprehensive healthcare services and want their medical history to be accurately documented.
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Existing Avera patients who may need to update their health history due to changes in their medical conditions or medications.
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Individuals undergoing medical procedures or surgeries who require a thorough understanding of their medical background for safe and effective treatment.
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The health history - avera is a comprehensive record of an individual's medical and health information, including past illnesses, family medical history, medications, allergies, and surgeries.
Anyone who receives healthcare services from a healthcare provider or institution that uses the health history - avera system is required to file their health history.
To fill out the health history - avera, individuals need to provide accurate and detailed information about their medical history, including past illnesses, surgeries, medications, allergies, and family medical history. This information can be inputted electronically through the health history - avera system or provided in person to a healthcare provider.
The purpose of the health history - avera is to provide healthcare providers with a comprehensive overview of an individual's medical history, allowing them to make informed decisions about patient care, treatment plans, and medication prescriptions.
The health history - avera system requires individuals to report information such as past illnesses, surgeries, medications, allergies, family medical history, and current health conditions.
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