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RIVERSIDE SURGERY 48 WORTH ING ROAD FORDHAM WEST SUSSEX RH12 1UD Telephone: 01403 274700 Fax: 01403 221999 NEW PATIENT Questionnaires Please complete this questionnaire and return it to the Surgery
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How to fill out new patient health questionnaire
How to fill out a new patient health questionnaire:
01
Start by reading through the entire questionnaire to familiarize yourself with the information requested.
02
Gather any relevant medical records or documents that may help you accurately complete the questionnaire.
03
Begin by filling out your personal information such as your name, date of birth, address, and contact details.
04
Make sure to provide accurate and up-to-date information regarding your medical history, including any past illnesses, surgeries, or chronic conditions.
05
Answer questions related to your family medical history, including any hereditary conditions that may run in your family.
06
Carefully complete the section regarding your current medications, including both prescription and over-the-counter drugs.
07
Provide any information related to your allergies or adverse reactions to medications or substances.
08
If applicable, provide details about your lifestyle habits, such as smoking, alcohol consumption, or dietary preferences.
09
Finally, review the completed questionnaire for any missing or incomplete information before submitting it to the healthcare provider.
Who needs a new patient health questionnaire:
01
Individuals who are seeking medical care from a new healthcare provider or facility may be required to fill out a new patient health questionnaire.
02
Patients who haven't visited a healthcare provider in a long time or those who have had significant changes in their health since their last visit may also need to fill out a new questionnaire.
03
New patient health questionnaires are typically required to establish a comprehensive medical history, gather information about current health status, and aid healthcare providers in providing appropriate care.
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What is new patient health questionnaire?
A new patient health questionnaire is a form that gathers information about a patient's medical history, current health status, and any symptoms or conditions they may have.
Who is required to file new patient health questionnaire?
All new patients visiting a healthcare provider are typically required to fill out a new patient health questionnaire.
How to fill out new patient health questionnaire?
To fill out a new patient health questionnaire, the patient must provide accurate information about their medical history, current health issues, medications, allergies, and lifestyle habits.
What is the purpose of new patient health questionnaire?
The purpose of a new patient health questionnaire is to help healthcare providers better understand the patient's health profile, make more informed diagnosis and treatment decisions, and ensure patient safety.
What information must be reported on new patient health questionnaire?
Information such as medical history, current health conditions, medications, allergies, previous surgeries, lifestyle habits, and family medical history must be reported on a new patient health questionnaire.
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