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St. James Catholic Church MEDICAL HISTORY FORM 2016/2017 Please read and complete both sides of this form for all minor children to provide clear instructions regarding permission for seeking medical

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How to fill out medical history form

01

To fill out a medical history form, follow these steps:

02

Start by providing your personal information, such as your full name, date of birth, and contact details.

03

Proceed to answer questions about your medical background, including any past illnesses, surgeries, or medical conditions.

04

Provide details about your family medical history, such as any hereditary diseases or conditions that run in your family.

05

Specify any current medications you are taking, including the dosage and frequency.

06

Answer questions related to your lifestyle habits, such as smoking, alcohol consumption, and exercise routine.

07

If applicable, provide information about any allergies or adverse reactions to medications.

08

Finally, review the form for completeness and accuracy before submitting it.

09

Remember to be honest and thorough while filling out the medical history form to ensure proper healthcare management.

Who needs medical history form?

01

Anyone seeking medical attention or undergoing a medical examination needs to fill out a medical history form.

02

This includes new patients visiting a healthcare provider for the first time, individuals undergoing surgery, or those participating in clinical trials.

03

Medical history forms help healthcare professionals understand a patient's medical background and provide appropriate treatment or care.

04

It allows doctors to identify any potential risks or complications based on the patient's medical history and make informed decisions regarding their health.

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