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PHYSICAL THERAPY MEDICAL HISTORY FORM Name: Date of Birth: / / Surname Given Name Initial Year Mon Day PLEASE ANSWER THE FOLLOWING QUESTIONS. 1. Have you received physical therapy assessment or treatment
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How to fill out physical therapy medical history:

01
Start by carefully reading the form: Take your time to read each question and understand what information is being asked for. This will help ensure that you provide accurate and relevant information.
02
Provide personal details: Begin by filling out your personal information such as your name, date of birth, address, and contact information. This helps in identifying your medical records and communicating with you if needed.
03
Mention previous medical conditions: The form may ask about any past or current medical conditions you have or had. Be thorough and provide details about the condition, treatments received, and any relevant medical history.
04
List your medications: You may be required to list any medications you are currently taking, including dosage and frequency. Include both prescription and over-the-counter medications, as well as any supplements or herbal remedies.
05
Note any allergies or sensitivities: It is important to disclose any known allergies or sensitivities to medications, food, or environmental factors. This information is crucial to ensure your safety during physical therapy sessions.
06
Mention previous surgeries or procedures: If you have had any surgeries or procedures in the past, include details such as the type of surgery, date, and any complications or follow-up treatments involved.
07
Provide a brief medical history: The form may ask for a summary of your medical history, including any chronic conditions, major illnesses, or hospitalizations. Be concise but thorough in providing this information.
08
Include information about your current condition: Describe the specific reason for seeking physical therapy and provide details about any recent injuries, accidents, or conditions that led to your need for therapy.

Who needs physical therapy medical history?

Physical therapy medical history is typically required for individuals who are seeking or undergoing physical therapy treatment. This includes patients who have suffered injuries, are recovering from surgeries, or are dealing with conditions that impact their physical functioning.
It is important for physical therapists to have a comprehensive understanding of a patient's medical history to design appropriate treatment plans, ensure patient safety, and tailor therapy sessions to individual needs. By having access to the patient's medical history, physical therapists can make informed decisions and provide optimal care for their patients.
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Physical therapy medical history is a document that contains information about a patient's past medical conditions, surgeries, medications, and any other relevant health information that may impact their physical therapy treatment.
Patients who are undergoing physical therapy are required to provide their medical history to their physical therapist.
Physical therapy medical history can be filled out by the patient or with the assistance of their healthcare provider. It typically involves providing details about past medical conditions, surgeries, medications, and any current health concerns.
The purpose of physical therapy medical history is to help the physical therapist understand the patient's medical background and tailor their treatment plan to meet the individual needs of the patient.
Information that must be reported on physical therapy medical history includes past medical conditions, surgeries, medications, allergies, and any current health concerns.
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