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Program International Triathlon Union (ITU) MEDICAL DIAGNOSTICS FORM FOR ATHLETES WITH VISUAL IMPAIRMENT Please complete the form in capital letters The form must be completed in capital letters by
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Gather necessary personal information such as full name, date of birth, address, and contact details.
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Provide relevant medical history, including any past diagnoses, allergies, surgeries, or chronic conditions.
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Fill in current symptoms or reasons for seeking medical diagnosis, including any specific concerns or changes in health.
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Provide a detailed list of current medications, supplements, or treatments being taken.
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Answer questions regarding lifestyle factors such as smoking, alcohol consumption, exercise routine, and diet.
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Provide information about family medical history, including any hereditary conditions or illnesses.
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Review the completed form for accuracy and ensure all sections are properly filled out.

Who needs medical diagnostics form for:

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Patients visiting a new healthcare provider or specialist to establish a medical history and provide relevant information for diagnosis.
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Individuals undergoing comprehensive medical check-ups or screenings to assess overall health and detect early signs of potential illnesses.
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Patients seeking a second opinion or consulting different specialists to obtain a thorough evaluation and accurate diagnosis.
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The purpose of the medical diagnostics form is to document and track a patient's medical tests, results, and overall health history.
The medical diagnostics form should include details about the patient's personal information, medical tests, results, and any relevant medical history.
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