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SURGICAL HISTORY AND PHYSICAL FORM Patient Name Date Gender Male Female Birthday Referring Physician Reason for Visit ALLERGIES: None (Please note reaction for each medication) LATEX ALLERGY YES NO

How to fill out surgical history and physical

How to fill out surgical history and physical:

1. Start by gathering all relevant information about the patient's previous surgeries. This includes the type of surgery, the date of the surgery, the name of the surgeon, and any complications or side effects that occurred.
2. Once you have all the necessary information, begin filling out the surgical history section of the form. This section typically asks for details about any previous surgeries the patient has undergone. Be sure to provide accurate and specific information about each surgery.
3. Next, move on to the physical history section. This part of the form requires information about the patient's overall health, past medical conditions, and any current medications they are taking. It's important to include any relevant details, such as allergies or chronic illnesses.
4. Make sure to fill out the physical examination section carefully. This section usually involves a thorough examination of the patient's body, including vital signs, reflexes, and any visible abnormalities or abnormalities detected through tests.
5. Finally, review the completed form for accuracy and completeness. Double-check all the information provided before submitting it.

Who needs surgical history and physical?

1. Surgeons and other medical professionals: Surgical history and physical are essential for surgeons and medical professionals who need to understand a patient's medical background before performing surgery or administering treatment. This information helps them assess the potential risks and complications associated with a specific procedure.
2. Anesthesiologists: Anesthesiologists rely on surgical history and physical to determine the appropriate anesthesia and medication dosages for patients. This information helps them ensure the patient's safety and well-being during surgery.
3. Primary care physicians: Surgical history and physical are also important for primary care physicians who need to have a comprehensive understanding of their patient's medical history to provide appropriate ongoing care and treatment.
4. Medical researchers and academics: Surgical history and physical data can be valuable for medical researchers and academics to study trends, outcomes, and complications related to surgeries. This information can contribute to advancements in surgical techniques and patient care.

In conclusion, filling out the surgical history and physical form requires careful attention to detail and accurate information. This information is crucial for various medical professionals involved in a patient's care, from surgeons to anesthesiologists, primary care physicians, and medical researchers.

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