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Medical History, Physical Examination and Immunization Form
Western New England College Health Services
1215 Abraham Road, Springfield, MA 01119
Phone 413-782-1211 Fax 413-796-2255
For fall registration
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What is medical history physical examination?
Medical history physical examination is a comprehensive assessment of an individual’s past and current medical conditions, including any surgeries, illnesses, medications, allergies, and family medical history.
Who is required to file medical history physical examination?
Individuals who are undergoing a medical check-up, applying for health insurance or disability benefits, or seeking medical treatment may be required to file medical history physical examination.
How to fill out medical history physical examination?
To fill out a medical history physical examination form, individuals need to provide accurate and complete information regarding their medical history, including past and current illnesses, surgeries, medications, allergies, and family medical history, as requested on the form.
What is the purpose of medical history physical examination?
The purpose of a medical history physical examination is to gather comprehensive information about an individual's medical background, which can aid healthcare professionals in diagnosing and treating medical conditions effectively.
What information must be reported on medical history physical examination?
Information that must be reported on a medical history physical examination typically includes details of past and current medical conditions, surgeries, illnesses, medications, allergies, and family medical history.
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