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GENERAL HEALTH HISTORY AGES 13 ADULT Patient Information Patients Legal Name: ___ Preferred Name: ___ Date: ___ Address: ___ City: ___ Postal Code:___ Telephone Home #: ___Work #: ___Cell Provider
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How to fill out general health history

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Access the general health history form
02
Start by filling out personal information such as name, date of birth, and contact information
03
Provide details about any existing medical conditions or chronic illnesses
04
List any medications you are currently taking, including dosage and frequency
05
Include information about any known allergies or sensitivities to medications or foods
06
Detail any previous surgeries or hospitalizations
07
Mention any family history of medical conditions or hereditary illnesses
08
Sign and date the form to confirm accuracy and completeness

Who needs general health history?

01
General health history is needed by healthcare providers, doctors, nurses, and other medical professionals
02
It is also necessary for insurance companies, employers, and researchers to understand an individual's health background
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General health history is a record of an individual's overall health status, including past illnesses, medications, surgeries, and family medical history.
All individuals are required to provide their general health history when requested by healthcare providers or medical professionals.
General health history can be filled out by providing accurate and detailed information about your medical background, including any chronic conditions, medical treatments, and family history of diseases.
The purpose of general health history is to help healthcare providers assess an individual's health risks, make informed decisions about treatment options, and provide appropriate care.
General health history should include details about past illnesses, surgeries, medications, allergies, family medical history, lifestyle habits, and any other relevant health information.
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