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PHYSICAL ASSESSMENT TO BE COMPLETED BY HOSPITAL STAFF (MD or RN) Assessment Performed by: / / / Print Name and Title MD or RN Signature D M Y Time Evidence of: Nonmedical injection of drugs Jaundice
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How to fill out a physical assessment form:

01
Start by reading and understanding the instructions: Before filling out the physical assessment form, carefully read the instructions provided. This will help you understand the purpose of the assessment and the specific information that needs to be recorded.
02
Provide personal information: Begin by entering your personal information, such as your full name, date of birth, address, contact details, and any other required details. This helps to identify the individual undergoing the assessment.
03
Medical history: The physical assessment form will often require you to provide your medical history. This includes details about any past illnesses, surgeries, or chronic conditions you may have had. It is important to be thorough and accurate in providing this information as it helps healthcare professionals assess your current health status.
04
Medications and allergies: Indicate any medications you are currently taking, including prescription drugs, over-the-counter medications, and any herbal supplements. It is also essential to list any known allergies or adverse reactions you have to medications or substances.
05
Lifestyle and habits: The physical assessment form may inquire about your lifestyle and habits, such as smoking, alcohol consumption, exercise routines, and dietary habits. This information assists healthcare professionals in evaluating your overall health and potential risk factors.
06
Present symptoms or concerns: If you are undergoing a physical assessment due to specific symptoms or concerns, describe them in detail on the form. This includes any pain, discomfort, changes in bodily functions, or other signs that require attention. Including this information helps healthcare professionals address your specific needs during the assessment.
07
Review and sign: After completing the form, carefully review all the information you have provided, ensuring its accuracy and completeness. If satisfied, sign and date the form as required. Your signature indicates that the information you have provided is true and correct to the best of your knowledge.

Who needs a physical assessment?

01
Individuals seeking employment: Many occupations require individuals to undergo physical assessments to determine their fitness for specific job roles. This is common in physically demanding professions such as firefighting, law enforcement, or jobs involving heavy lifting.
02
Athletes and sports participants: Athletes often undergo physical assessments to evaluate their overall health and fitness levels. These assessments help identify any potential areas of improvement, address injuries or concerns, and design appropriate training programs.
03
Individuals undergoing medical treatment: Physical assessments are often part of the diagnostic process for various medical conditions. Doctors and healthcare professionals may require a physical assessment to assess an individual's overall health and potentially identify any underlying health issues.
04
Individuals starting a wellness program: Many wellness programs, such as weight loss or health improvement programs, require a baseline physical assessment to track progress and identify potential health risks or considerations.
05
Routine healthcare check-ups: Physical assessments are a routine part of healthcare check-ups, allowing doctors and healthcare providers to evaluate an individual's current health status, identify potential risks, and provide appropriate healthcare advice.
Remember, physical assessments are conducted by trained professionals who use the information gathered to determine your health status, guide treatment plans, and provide personalized care.
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Physical assessment is a medical evaluation to determine an individual's physical abilities and limitations.
Individuals who are applying for certain job positions or participating in certain activities may be required to file a physical assessment.
Physical assessments are typically filled out by a qualified healthcare professional, such as a doctor or nurse, based on the individual's medical history and current physical condition.
The purpose of a physical assessment is to ensure that an individual is physically capable of performing certain tasks or activities safely.
Physical assessments typically include information on the individual's medical history, current physical condition, and any limitations or restrictions.
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