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PATIENT HISTORY AND PHYSICAL FORM Name LAST FIRST MIDDLE I SSN Date of Birth Age Sex Marital Status Occupation Home Address City State Zip Code Home Phone Cell Phone Work Phone Email Address Emergency Contact Phone How were you referred to our office Height Weight BMI Allergies Social History Do you smoke Yes No Do you drink alcohol Yes How many packs per day Quit yrs ago No Do you use recreational drugs Yes How frequently Surgical History Surgery Year Surgeon/City Medical History Diabetes...

How to fill out patient history and physical

How to fill out patient history and physical

1. Gather necessary forms and documents, such as medical history forms and physical examination forms.
2. Start with the patient's personal information, including their name, date of birth, address, and contact details.
3. Ask the patient about their medical history, including any past illnesses, surgeries, or chronic conditions.
4. Collect information about the patient's family medical history to identify any genetic or hereditary conditions.
5. Document the patient's current medications, including prescription drugs, over-the-counter medications, and herbal supplements.
6. Ask the patient about any allergies or adverse reactions they may have to certain medications or substances.
7. Perform a detailed review of systems, asking the patient about symptoms related to each body system.
8. Conduct a physical examination, including vital signs (heart rate, blood pressure, temperature, etc.), general appearance, and examination of specific body parts or systems.
9. Document the findings from the physical examination accurately and objectively.
10. Summarize the patient's medical history and physical examination findings in a concise and organized manner.
11. Review and verify the completed patient history and physical for accuracy and completeness.
12. Communicate any important findings or concerns to the appropriate healthcare provider or specialist.

Who needs patient history and physical?

1. Patients who are seeking medical care from a healthcare provider or institution will require a patient history and physical.
2. Hospitals, clinics, and other medical facilities often require a patient history and physical before providing treatment or performing procedures.
3. Patients undergoing surgery or other invasive procedures will need a patient history and physical to assess their overall health and potential risks.
4. Individuals with chronic illnesses or complex medical conditions may require regular patient history and physical evaluations to monitor their health status.
5. Health insurance companies may request a patient history and physical as part of the evaluation process for coverage or reimbursement purposes.

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What is patient history and physical?

Patient history and physical is a documented record of a patient's medical history, current medications, allergies, past surgeries, and physical examination findings.

Who is required to file patient history and physical?

Healthcare professionals such as doctors, nurses, or physician assistants are required to file patient history and physical.

How to fill out patient history and physical?

Patient history and physical is typically filled out by conducting interviews with the patient, reviewing medical records, and performing a physical examination.

What is the purpose of patient history and physical?

The purpose of patient history and physical is to provide healthcare providers with essential information about a patient's health status, which can aid in diagnosis and treatment planning.

What information must be reported on patient history and physical?

Patient history and physical must include details about the patient's medical history, current medications, allergies, past surgeries, and findings from the physical examination.