Get the free PHYSICAL EVALUATION HISTORY FORM - Lindenwold High School

PARTICIPATION PHYSICAL EVALUATION HISTORY FORM (Note: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep a copy of this form in the chart.)

How to fill out physical evaluation history form

How to fill out a physical evaluation history form:

1. Start by carefully reading the instructions provided on the form. This will give you an idea of what information needs to be provided and how it should be formatted.
2. Begin by filling out your personal details such as your name, contact information, and date of birth. Make sure to write legibly and double-check for any errors.
3. The form may require you to provide information about your medical history. This could include any previous illnesses, surgeries, or ongoing medical conditions. Be thorough and provide accurate dates and details.
4. You may be asked to indicate any medications you are currently taking. Make a list of all the medications, including the dosage and frequency of intake. If you are unsure about any medications, it's always best to consult with your healthcare provider.
5. The form might also ask about any allergies you have. Include any known allergies to medications, food, or environmental factors.
6. Be prepared to provide information about your family's medical history as well. This could include any genetic conditions or diseases that run in your family.
7. Depending on the purpose of the evaluation, you may need to provide information about your lifestyle habits such as smoking, alcohol consumption, exercise routine, and diet.
8. If you have any specific concerns or questions, it's advisable to consult with your healthcare provider before filling out the form to ensure accuracy and completeness.
9. Once you have completed filling out the form, review it to ensure all information is accurate and legible. Then sign and date the document as required.
10. Keep a copy of the completed form for your records before submitting it to the relevant healthcare provider.

Who needs a physical evaluation history form?

1. People who are seeking medical care from a new healthcare provider may be required to fill out a physical evaluation history form. This helps the healthcare professional gain an understanding of the patient's overall health and medical background.
2. Individuals who are participating in certain sports activities or joining a fitness program may need to fill out a physical evaluation history form. This is crucial for assessing the individual's physical capabilities and potential risks involved.
3. Job applicants in certain industries such as aviation, law enforcement, or healthcare may need to complete a physical evaluation history form as part of their pre-employment process. Employers use this information to ensure that the candidate is physically fit for the job and can safely perform their duties.

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