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SRC Health History Form Name: Home Phone () Cell Phone () LastFirstMiddleAddress City State Zip Code P.O. Box or mailing addressOccupation Business Phone Date of Birth / / Sex: M F Email Text message

How to fill out srjc health history form

How to fill out srjc health history form

1. To fill out the SRJC Health History Form, follow these steps:
2. Start by gathering all the necessary information, such as your personal details, medical history, and current medications.
3. Read the form carefully to understand the information required and any specific instructions.
4. Begin by providing your personal details, including your full name, date of birth, and contact information.
5. Fill in your medical history, including any previous illnesses, surgeries, or chronic conditions you have had.
6. Provide details about any current medications you are taking, including the name, dosage, and frequency.
7. Answer all the questions honestly and accurately, as it is crucial for your healthcare provider to have a complete understanding of your health.
8. If there are any sections that you are unsure about or do not apply to you, seek clarification from a healthcare professional or leave the section blank if permitted.
9. Review the completed form to ensure all fields are filled correctly and there are no missing or mistaken information.
10. Sign and date the form, indicating that the information provided is true and accurate to the best of your knowledge.
11. Submit the form as per the instructions provided by SRJC, whether it is by mail, fax, or in person.
12. Remember to keep a copy of the completed form for your records.

Who needs srjc health history form?

1. The SRJC Health History Form needs to be filled out by individuals who are enrolling in classes or participating in activities at Santa Rosa Junior College (SRJC). This includes new students, returning students, and individuals taking part in specific programs or events that require health information. It is important for SRJC to have this form on file to ensure the safety and well-being of all students and participants.

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What is srjc health history form?

The SRJC health history form is a document required by Santa Rosa Junior College that collects essential health-related information from students.

Who is required to file srjc health history form?

All incoming students, particularly those who are planning to participate in health programs or activities that require a medical examination, are required to file the SRJC health history form.

How to fill out srjc health history form?

To fill out the SRJC health history form, students should carefully read the instructions, provide accurate personal and health information, and submit it to the designated office as indicated on the form.

What is the purpose of srjc health history form?

The purpose of the SRJC health history form is to ensure that the college has adequate health information to promote student safety and well-being in academic and extracurricular activities.

What information must be reported on srjc health history form?

The information that must be reported includes personal identification details, medical history, allergies, current medications, and any ongoing health conditions.