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HEALTH HISTORY AND PHYSICAL EXAM 20162017 Return by August 1, 2016. ALL SECTIONS ARE REQUIRED AND MUST BE COMPLETED. Your children healthcare professional should complete pages 4 and 5. $75 LATE FEE
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How to fill out health history and physical:

01
Start by gathering all relevant medical documents and information, such as previous medical records, prescriptions, and any recent lab results.
02
Begin the health history form by providing basic personal information, including your name, date of birth, and contact details.
03
Fill in any family medical history, including any hereditary conditions that may run in your family, such as heart disease, diabetes, or cancer.
04
Provide a comprehensive list of medications you are currently taking, including the dosage and frequency. It's important to include both prescription and over-the-counter medications, as well as any supplements or herbal remedies.
05
Detail your medical history, including any past illnesses, surgeries, or hospitalizations. Be sure to mention any chronic conditions or ongoing medical concerns you may have.
06
Note any allergies or adverse reactions you have experienced in the past, such as allergic reactions to medications, food, or environmental triggers.
07
Fill out the section on lifestyle habits, such as smoking, alcohol consumption, exercise frequency, and diet. It's important to provide honest and accurate information to help assess your overall health.
08
Mention any recent changes in your health or new symptoms that you have experienced since your last physical examination.
09
When filling out the physical form, provide accurate measurements of vital signs, such as blood pressure, heart rate, weight, and height.
10
The physical examination will typically involve a thorough assessment of various body systems, including the cardiovascular system, respiratory system, musculoskeletal system, and neurological system.

Who needs health history and physical:

01
Individuals who are scheduled to undergo surgery or medical procedures may be required to fill out a health history and physical form. This is to ensure that medical professionals have a comprehensive understanding of an individual's health status before proceeding with any invasive procedures.
02
Students participating in sports or other physical activities, especially at competitive levels, may be required to provide a health history and physical evaluation to ensure that they are medically fit to participate.
03
People seeking employment in certain industries, particularly those involving physical labor or potentially hazardous conditions, may be required to submit a health history and physical exam as part of the pre-employment screening process.
04
Insurance companies may request a health history and physical evaluation as part of the underwriting process to assess the risk associated with insuring an individual.
05
Individuals seeking primary care or establishing a new relationship with a healthcare provider may be asked to fill out a health history form to provide a comprehensive overview of their medical background.
Remember to consult with a healthcare professional if you have any specific concerns or questions regarding filling out a health history or physical form.
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Health history and physical is a record of a person's past illnesses, injuries, treatments, and surgeries, as well as a current physical examination.
Health history and physical are typically required to be filed by individuals seeking medical treatment, such as patients visiting a doctor for a check-up or before a surgery.
Health history and physical forms are usually filled out by the individual, providing details about their medical history, current medications, and any symptoms or concerns.
The purpose of health history and physical is to provide healthcare providers with important information about a person's medical background, which can help in diagnosing and treating health conditions.
Information such as past medical conditions, surgeries, hospitalizations, allergies, medications, family history of diseases, and current symptoms should be reported on health history and physical forms.
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