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Page 5The University of Texas at AustinDepartment of Intercollegiate AthleticsREQUIRED MEDIA L FORMS5/5PREACTIVITY CLEARANCE EXAMINATION: PHYSICAL AUTHORIZATION You may submit a copy of a completed
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Read the instructions on the form carefully to understand what information needs to be provided.
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Start filling out the form by entering your personal information such as name, date of birth, address, and contact details.
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Provide details about your medical history, including previous illnesses, surgeries, medications taken, and any known allergies.
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If there are specific sections in the form for different categories of medical history (e.g., family medical history, current symptoms), make sure to fill those out accurately.
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Patients may also need to fill out a PDF medical history form to provide their medical information to healthcare providers.
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A PDF medical history form is a document used to compile an individual's medical history, including past illnesses, surgeries, medications, allergies, and family medical history, usually in a standardized format for healthcare providers.
Individuals seeking medical treatment, participating in clinical studies, or applying for health insurance are typically required to file a PDF medical history form.
To fill out a PDF medical history form, download the form, complete all sections with accurate information about your medical history, including personal details, medical conditions, and treatments, and then save or print the completed form.
The purpose of a PDF medical history form is to provide healthcare providers with essential information to assess a patient's health, diagnose conditions, plan treatments, and ensure safe and effective care.
The information that must be reported includes personal identification details, medical conditions, surgeries, medications, allergies, immunizations, and family medical history.
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