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Mercy Clinic Gun Oncology Patient History Name___DOB___ Age___ Date___Primary Physician ___ Referring Physician ___ Problems: (State reasons you want to see a doctor. List in order of importance to
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How to fill out gynecologic oncology health history

01
Obtain the gynecologic oncology health history form from the healthcare provider's office.
02
Fill out personal information such as name, date of birth, address, and contact information.
03
Document any relevant medical history, including previous surgeries, medications, and medical conditions.
04
Provide information about family history of cancer or gynecologic diseases.
05
Include any symptoms or concerns related to gynecologic health.
06
Fill out any lifestyle factors that may impact gynecologic health, such as smoking or alcohol consumption.

Who needs gynecologic oncology health history?

01
Individuals who are seeking treatment or evaluation for gynecologic cancers or diseases.
02
Patients who have a family history of gynecologic cancers and want to assess their own risk.
03
Healthcare providers who need a comprehensive overview of a patient's gynecologic health.
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Gynecologic oncology health history is a record of a patient's medical background related to gynecologic cancers.
Patients who are undergoing treatment for gynecologic cancers are required to file gynecologic oncology health history.
Gynecologic oncology health history can be filled out by providing accurate information about past medical conditions, treatments, and family history related to gynecologic cancers.
The purpose of gynecologic oncology health history is to provide healthcare providers with important information to assist in the diagnosis and treatment of gynecologic cancers.
Information such as personal medical history, family history of gynecologic cancers, past treatments, and current symptoms must be reported on gynecologic oncology health history.
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