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Industrial Hand and Physical Therapy PATIENT MEDICAL HISTORY Name: Family Physician: Last Date Worked Due to this Injury: Is an Attorney Involved in this Case? Have you had Surgery for this Injury?
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What is past medical history form?
Past medical history form is a document that contains information about a person's previous health conditions, treatments, surgeries, and medications.
Who is required to file past medical history form?
Patients who are seeking medical care or treatment are typically required to fill out a past medical history form.
How to fill out past medical history form?
To fill out a past medical history form, individuals need to provide accurate and detailed information about their medical history including past illnesses, surgeries, medications, allergies, and family history of diseases.
What is the purpose of past medical history form?
The purpose of past medical history form is to provide healthcare providers with important details about a patient's health history which can help in making accurate diagnoses and treatment plans.
What information must be reported on past medical history form?
Information such as past illnesses, surgeries, medications, allergies, family history of diseases, and current health conditions must be reported on past medical history form.
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