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UPDATED PERSONAL/ HEALTH HISTORY Madison Pediatric Dental and Orthodontics Producing Great Smiles! Dr. Douglas Wilson Dr. Thomas Wen ham Dr. Grace Wen ham 100 River Place, Suite 110 Madison, WI 53716
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Start by opening the download health history update form on your computer or device.
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Fill in your personal information, including your full name, date of birth, and contact information. This will help ensure accurate record-keeping and easy communication if needed.
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Provide details about any pre-existing medical conditions you have, including any chronic illnesses, allergies, or surgeries you have undergone. Be as specific as possible to ensure accurate information on file.
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Indicate your current medications, dosage, and frequency of use. This is important for healthcare providers to have a complete overview of your medication regimen.
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Answer any questions regarding your family medical history. This information helps healthcare professionals understand any potential hereditary conditions that might be relevant to your health.
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Enter information about your vaccination history, including any recent immunizations you have received.
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Provide details about any recent medical procedures or hospitalizations you have undergone. This allows healthcare providers to have a comprehensive understanding of your medical history.
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Who needs a download health history update?

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Individuals who are seeing a new healthcare provider and need to provide up-to-date medical information.
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Individuals participating in clinical trials or research studies that require comprehensive health information.
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Individuals who are proactive in managing their health and want to ensure accurate and updated medical records are on file.
Remember, filling out a download health history update form is crucial for healthcare providers to have a complete understanding of your medical background and to provide you with the best possible care.
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It is a form used to update an individual's health history.
Individuals who have experienced changes in their health since their last update.
The form can typically be filled out online or in person with a healthcare provider.
The purpose is to ensure that healthcare providers have the most up-to-date information on an individual's health.
Details about any changes in medical conditions, medications, allergies, and surgeries.
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