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PARTICIPATION PHYSICAL EVALUATION MEDICAL HISTORY2017This MEDICAL HISTORY FORM must be completed annually by parent (or guardian) and student in order for the student to participate in athletic activities.

How to fill out history and physical form

How to fill out history and physical form

1. Start by filling out the patient's personal information, including their name, date of birth, and contact information.
2. Provide details about the patient's medical history, including any past surgeries, illnesses, or chronic conditions.
3. Document the patient's current medications, including dosage and frequency.
4. Ask the patient about any allergies or adverse reactions to medications.
5. Include information about the patient's family history of diseases or conditions.
6. Record the patient's social history, such as their occupation, tobacco or alcohol use, and exercise habits.
7. Perform a thorough physical examination and document the findings.
8. Provide a summary of the patient's overall health status and any specific concerns or recommendations.
9. Sign and date the form to confirm its accuracy and completeness.

Who needs history and physical form?

1. The history and physical form is typically needed by healthcare providers, including doctors, nurses, and other medical personnel.
2. It is necessary for new patients, as well as for patients who require an updated assessment of their health status.
3. The form is used to gather important information about the patient's medical history, physical examination findings, and overall health.

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What is history and physical form?

History and physical form is a document used by healthcare providers to record details of a patient's medical history and physical examination.

Who is required to file history and physical form?

Healthcare providers are required to file history and physical form for their patients.

How to fill out history and physical form?

History and physical form can be filled out by healthcare providers during a patient visit, documenting the patient's medical history and physical examination findings.

What is the purpose of history and physical form?

The purpose of history and physical form is to provide healthcare providers with essential information about a patient's medical history and current physical condition.

What information must be reported on history and physical form?

Information such as past medical history, current medications, allergies, family history, vital signs, and physical examination findings must be reported on history and physical form.