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This document is a comprehensive medical history questionnaire for patients seeking bariatric surgery at the Johns Hopkins Center for Bariatric Surgery. It collects personal information, medical history,
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How to fill out medical history questionnaire
How to fill out medical history questionnaire
01
Start with your personal information: Enter your full name, date of birth, and contact details.
02
List any allergies: Specify any medications, food, or environmental allergies.
03
Provide your medical history: Include past illnesses, surgeries, and hospitalizations.
04
Detail family medical history: Note any significant health conditions in your immediate family.
05
List current medications: Include prescribed and over-the-counter medications you are taking.
06
Note lifestyle factors: Include information on your smoking, drinking, and exercise habits.
07
Review for completeness: Ensure all sections are filled out thoroughly and accurately before submission.
Who needs medical history questionnaire?
01
Patients visiting a new healthcare provider.
02
Individuals undergoing pre-operative assessments.
03
Participants in clinical trials or research studies.
04
Anyone needing to update their medical records for ongoing care.
05
People seeking health insurance coverage.
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What is medical history questionnaire?
A medical history questionnaire is a document used to gather comprehensive information about a patient's past and present health conditions, medications, allergies, surgeries, and lifestyle factors.
Who is required to file medical history questionnaire?
Typically, patients seeking medical treatment, participating in clinical trials, or undergoing certain procedures are required to fill out a medical history questionnaire.
How to fill out medical history questionnaire?
To fill out a medical history questionnaire, patients should read each question carefully, provide accurate answers to the best of their knowledge, and mention any relevant medical information. It's advisable to consult with a healthcare provider if unsure about any details.
What is the purpose of medical history questionnaire?
The purpose of a medical history questionnaire is to help healthcare providers understand a patient's health background, identify potential risks, personalize treatment plans, and enhance patient safety.
What information must be reported on medical history questionnaire?
Patients must report information such as previous illnesses, surgeries, medical conditions, family medical history, current medications, allergies, and lifestyle habits like smoking and alcohol use.
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