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03.02.01.05 MEDICAL QUESTIONNAIRE 1. PERSONAL DETAILS (please write in capital letters) Mr. Mrs. Miss Family Name First name Fathers first name Mothers first name Date of Birth: Day Month Year Address
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How to fill out a medical questionnaire - ecole?
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Start by reading the instructions: Before you begin filling out the medical questionnaire - ecole, it is essential to carefully read the accompanying instructions. These instructions will provide guidance on what specific information needs to be provided and how to properly fill out the questionnaire.
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Provide accurate personal information: The medical questionnaire - ecole typically requires you to provide personal details such as your full name, contact information, date of birth, and any relevant identification numbers. Ensure that you enter this information accurately to avoid any confusion or potential mix-ups.
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Detail your medical history: One of the main purposes of the medical questionnaire - ecole is to gather information about your medical history. It is crucial to be thorough and honest when providing this information. Include any pre-existing medical conditions, allergies, surgeries, or medications you are currently taking. This information helps the school assess your health needs and provide appropriate care if necessary.
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Provide emergency contact details: In case of any medical emergencies, it is vital to list the contact information for a designated emergency contact person. This person should be someone who can be reached readily and is aware of your medical history and any specific needs.
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Date and sign the questionnaire: Once you have filled out all the required sections of the medical questionnaire - ecole, make sure to date and sign it. By signing, you are indicating that the information provided is accurate and complete to the best of your knowledge.
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