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Exhibit 11-Page 1 of 108 CITY OF JOINVILLE, REPORT TO THE CITY COUNCIL 17301 133rd Avenue NE, Joinville, WA 98072 WWW. Cl.JOINVILLE.WA. Unto: From: By: Subject:Date: 1/5/2016Honorable City Council
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Answer the medical history questions by selecting the appropriate options or providing specific details as required.
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Anyone who is required to provide their health history information for a particular purpose might need to fill out an online health history form. This can include individuals seeking medical treatment, applying for health insurance, participating in clinical trials, or undergoing medical evaluations for employment or educational purposes.
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An online health history form is a digital document that allows individuals to provide their medical history and relevant health information to healthcare providers or institutions.
Typically, individuals seeking medical care, new patients registering at a healthcare facility, or participants in certain health programs are required to file the online health history form.
To fill out an online health history form, you generally need to provide personal details, medical history, medications, allergies, family health history, and any other relevant health information as prompted by the form.
The purpose of the online health history form is to ensure that healthcare providers have accurate and comprehensive information about a patient's health, enabling better diagnosis, treatment, and care.
Information required may include personal identification details, past medical and surgical history, current medications, allergies, immunization records, and family health history.
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