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JMJ TAMPA BAY, INC. 20192020 MEDICAL HISTORY FORM MEDICAL HISTORY(PLEASE FILL OUT ONE PER CHILD)CHILD NAME: ___ YES OR NO ALLERGIES ASTHMA DIABETES EPILEPSY HEADACHES HEART KIDNEY DISEASE MOTION SICKNESS
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How to fill out young child health history
How to fill out young child health history
01
Start by gathering all necessary information such as the child's personal information, medical history, vaccination record, and any known medical conditions.
02
Fill out the child's personal information including name, date of birth, gender, and contact information.
03
Provide information about the child's medical history such as any chronic illnesses, surgeries, or hospitalizations.
04
Include details about the child's vaccination record including dates of immunizations and any missed vaccinations.
05
Mention any known allergies or medication sensitivities that the child may have.
06
Don't forget to include emergency contact information in case of any medical emergencies.
Who needs young child health history?
01
Parents or caregivers of young children
02
Pediatricians or healthcare providers
03
Schools or daycare facilities
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What is young child health history?
Young child health history refers to a record of a child's medical and health information from birth up to a certain age.
Who is required to file young child health history?
Parents or legal guardians are typically required to file young child health history for their children.
How to fill out young child health history?
Young child health history can be filled out by providing detailed information about the child's medical history, vaccinations, allergies, and any existing health conditions.
What is the purpose of young child health history?
The purpose of young child health history is to monitor and track the child's health and development over time, and to ensure they receive appropriate medical care.
What information must be reported on young child health history?
Information such as the child's birth weight, immunization records, past illnesses, allergies, and any medications they are currently taking must be reported on young child health history.
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