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DIABLO DERMATOLOGY 3436 Hillcrest Ave., Suite 150, Antioch, CA 94531 (925) 754-6767 www.diablodermatology.com MEDICAL HISTORY Patient Name: Referred by: Date: Self Family/Friend Doctor s Name: 1.

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How to fill out medical history - diablo?

01

Start by providing your personal information such as your name, date of birth, and contact details. This will ensure that the medical history form is properly identified.

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Include information about your medical conditions and diagnoses. Mention any chronic illnesses, previous surgeries, or significant medical events you have experienced. This information will help healthcare providers understand your medical background.

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Note down any allergies or adverse reactions to medications. This is crucial as it helps healthcare providers prescribe appropriate medications and avoid any potential complications.

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Include information about your current medications. List the name, dosage, and frequency of any medications or supplements you are currently taking. This will assist healthcare providers in assessing potential interactions or contraindications.

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Document your family medical history. Provide details about any hereditary conditions, diseases, or illnesses that run in your family. This information helps healthcare providers assess your risk factors.

Who needs medical history - diablo?

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Patients visiting a new healthcare provider. When you see a new doctor or specialist, they will typically require a complete medical history, including information specific to the condition for which you are seeking treatment, such as diablo.

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Individuals with chronic illnesses or complex medical conditions. Patients with conditions that require ongoing management, such as diabetes, heart disease, or cancer, need to maintain a comprehensive medical history that tracks their treatment and progress.

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Emergency medical personnel. In emergency situations, having a complete medical history, especially for individuals with pre-existing conditions, can significantly impact the treatment decisions made by emergency responders.

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Legal and insurance purposes. Medical history information may be required for legal cases, insurance claims, or disability evaluations to determine the impact of medical conditions on a person's health and well-being.

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Medical history - diablo is a record of an individual's past health conditions, treatments, surgeries, and medications.

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Information such as pre-existing conditions, allergies, past surgeries, and current medications must be reported on medical history - diablo.

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