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Program: ___ Student ID: ___3041 West Avenue K Lancaster, CA 935365426HEALTH HISTORY AND PHYSICAL EXAMINATION NAME:Last ___DATE OF BIRTH: ___First ___ Middle ___ PHONE NO. ___MF(Circle one)NEXT OF
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Read the physical exam form thoroughly to understand the requirements and sections.
02
Fill in your personal information such as name, date of birth, address, and contact details.
03
Provide your medical history, including any previous illnesses, surgeries, or chronic conditions.
04
Mention any allergies or sensitivities to medication.
05
Record your vital signs such as blood pressure, pulse rate, respiratory rate, and temperature.
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Describe your current medications, if any.
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Provide details about your immunization history.
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Document any known medical conditions or disabilities.
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Complete the form by signing and dating it.
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Submit the filled physical exam form to the relevant authority or institution.

Who needs physical exam form student?

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Students who are applying for admission to educational institutions, such as schools, colleges, or universities, may need to fill out a physical exam form.
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Physical exam form student is a document that records the results of a medical examination performed on a student.
The student or their legal guardian is required to file the physical exam form.
Physical exam form student can be filled out by providing information about the student's medical history, current health status, and any medications they may be taking.
The purpose of physical exam form student is to ensure that the student is healthy and fit to participate in school activities.
Information such as medical history, current health status, vaccination records, and any relevant medical conditions must be reported on the physical exam form.
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