Get the free PHYSICAL EXAMINATION/MEDICAL HISTORY FORM

This form is used to collect physical examination and medical history information for participants of the Boston College Basketball Camp, including health conditions, parental authorization, and contact

How to fill out physical examinationmedical history form

How to fill out PHYSICAL EXAMINATION/MEDICAL HISTORY FORM

1. Start by writing your personal information, including your full name, date of birth, and contact details.
2. Provide your medical insurance information if applicable.
3. List your current medications along with their dosages.
4. Indicate any allergies you have, including food, medications, or environmental allergens.
5. Fill in your medical history, including past illnesses, surgeries, and any chronic conditions.
6. Include information about your family's medical history, noting any hereditary conditions.
7. Complete the lifestyle section, mentioning your exercise habits, diet, and substance use (tobacco, alcohol, drugs).
8. Answer any questions regarding your current health status or symptoms.
9. Sign and date the form to confirm that the information is accurate.

Who needs PHYSICAL EXAMINATION/MEDICAL HISTORY FORM?

1. Individuals seeking a medical check-up or routine physical examination.
2. Patients prior to surgeries or medical procedures.
3. Students entering schools or sports programs that require physical exams.
4. Workers undergoing occupational health assessments.
5. Individuals applying for life or health insurance policies.

People Also Ask about

How to document physical examination of patient?

A comprehensive physical examination documentation should include vital signs, general appearance, and systematic examination of each body system with specific findings recorded in a clear, organized format that supports patient care and improves clinical outcomes through enhanced communication.

How to document a patient's appearance?

Appearance Age: Does the patient appear to be his stated age, or does he look older or younger? Physical condition: Does he look healthy? Dress: Is he dressed appropriately for the season? Personal hygiene: Is he clean and well groomed, or unshaven and unkempt, with dirty skin, hair or nails?

What is the medical History and physical exam?

The H&P: History and Physical is the most formal and complete assessment of the patient and the problem. H&P is shorthand for the formal document that physicians produce through the interview with the patient, the physical exam, and the summary of the testing either obtained or pending.

What information must be included in the History and physical examination?

Patient age. diagnoses, the type and number of surgeries and procedures scheduled to be performed, comorbidities, and the level of anesthesia required for the surgery or procedure.

How to document a normal skin exam?

Sample Documentation of Expected Findings Skin is expected color for ethnicity without lesions or rashes. Skin is warm and dry with no edema. Capillary refill is less than 3 seconds. Normal skin turgor with no tenting.

What are the 5 physical examination techniques?

Physical examination is a vital skill for health care professionals, such as nurses, paramedics, pharmacists, and health care assistants. It is the process of evaluating the physical condition of a patient by using observation, palpation, percussion, auscultation, and smell.

How to document a patient assessment?

Document the patient's vital signs: Blood pressure. Pulse rate. Respiratory rate. SpO2 (also document supplemental oxygen if relevant) Temperature (including any recent fevers)

How to document an abdominal physical exam?

Sample Documentation of Expected Findings Abdominal contour is flat and symmetric. No visible lesions, pulsations, or peristalsis noted. sounds present and normoactive. Patient denies pain with palpation; no masses noted.

For pdfFiller’s FAQs

What is PHYSICAL EXAMINATION/MEDICAL HISTORY FORM?

The PHYSICAL EXAMINATION/MEDICAL HISTORY FORM is a document used to gather health information about an individual, which typically includes details about medical history, current health status, and findings from a physical exam conducted by a healthcare professional.

Who is required to file PHYSICAL EXAMINATION/MEDICAL HISTORY FORM?

Individuals such as athletes, students entering certain programs, or those applying for jobs that require health assessments are often required to file a PHYSICAL EXAMINATION/MEDICAL HISTORY FORM.

How to fill out PHYSICAL EXAMINATION/MEDICAL HISTORY FORM?

To fill out the PHYSICAL EXAMINATION/MEDICAL HISTORY FORM, individuals should provide accurate and complete information regarding their personal health history, current medications, allergies, and any previous medical conditions, and then seek a healthcare provider to perform and document the physical examination.

What is the purpose of PHYSICAL EXAMINATION/MEDICAL HISTORY FORM?

The purpose of the PHYSICAL EXAMINATION/MEDICAL HISTORY FORM is to assess an individual's health status, identify any potential health risks, and ensure that appropriate care can be provided based on their health needs.

What information must be reported on PHYSICAL EXAMINATION/MEDICAL HISTORY FORM?

The form typically requires information such as personal identification details, medical history (including past illnesses and surgeries), current medications, allergies, family health history, and findings from the physical examination performed by a healthcare professional.