67 Medical History Forms [Word, PDF]

Medical forms are there to help you. Today, you’ll across a wide variety of medical forms, each one different from the other in terms of function and feature. A medical form that is particularly useful for doctors and other medical staff is a medical history form. What is a medical history form and what does it entail? Let’s find out.

Whenever a new patient is admitted to the hospital for treatment, he/she is asked to fill out a medical history form along with the patient registration form. A medical history form is a means to provide the doctor your health history. With the help of the aforementioned form, the doctor will be able to provide you better care and treatment. So, what does your health/medical history show? An important document, medical history shows your diagnoses, symptoms, medical investigations, therapies, past diseases and chronic diseases running in your family. Generally, the medical history includes a summary of these things.

Medical History Form Templates

In addition to the doctors and other medical staff, insurance companies can also use the aforementioned form to determine a person’s insurability for medical or life insurance. However, this does not happen often. The form is mostly used for its original purpose which is providing doctors valuable information about the health history, care requirements, and risk factors of the patient. It is important for you to keep in mind that not every medical history form is the same. Just like the medical forms, the medical history form varies in terms of function and feature.

There are some history forms specific to certain types of medicine. For instance, psychiatrists may use history forms that have intensive and lengthy questions that deal solely with psychiatric issues and mental health. On the other hand, general physicians will require a history form that gives a good account of the health history of the patient and his/her family. The majority of the questions in the form require a yes/no response.

The importance of a medical history form

As mentioned above, a medical history form is one of the most useful medical forms available to doctors. Used by doctors to review the health pattern of the patient over time, a medical history form is not a replacement for a doctor’s medical files. However, this should not devalue the importance of the aforementioned form. In addition to helping a doctor review the patient’s health, a history form allows parents to compare the health of their children.

A handy reference tool, the aforementioned form provides crucial information required to decide a course of treatment. Also, the availability of a history form helps speed up emergency treatment. However, to ensure that, the history form must include the following things:

  • Your brief health history including your past health problems and surgeries
  • Your current medical conditions
  • Medications
  • Allergies
  • Your doctor and their contact information
  • Immunizations
  • Insurance information

As seen above, a medical history form increases your chances of surviving an emergency. Generally, when an unconscious person is brought into an emergency room, aside from the obvious injuries, the doctors know nothing about him/her. The doctor and other medical staff have no information about what the patient is allergic to, what medication he/she is taking and whether he/she had a surgery in the past.

While most hospitals make the effort to find the contact info of the patient’s family and notify them about the emergency as soon as possible, they are often so busy and understaffed that they fail to make the call in due time. Recently, there have been cases where people who had suffered a medical emergency died just because the doctors/medical staff had no idea about their health history and the medicines they were taking. Talking about access to medical information, you can sign a medical release form to allow hospitals and other medical service providers to release confidential patient information to a third party.

Coming back to the topic at hand, as seen above, communicating the vital medical information of person to doctors is extremely important. After all, it can help save a valuable life. Having a medication that doctors require to save your life on the tip of your tongue but not being able to spell it out is probably the worst situation to be in. In an emergency, the medications and phone numbers you know by heart will be of no use if you’re unable to reveal them to the doctor/medical staff.

Keeping your medications and emergency contact information a secret is not a sensible thing to do. At the very least, you should notify your doctor about them. You can notify your doctor about the medications you’re taking via a medical history form while an emergency contact form is a good way to provide emergency contact info. Now that you know the importance of a history form, it’s time to look at what’s included in the form and who needs to complete it.

Patient Medical History Form

Understanding the medical history form

It’s important that you’re as honest as possible when filing out the history form. There is no point of being dishonest in filling out the form as the only person who’ll be harmed by this is you. In fact, if you fill out the form for insurance purpose and provide incorrect information, you may become eligible for legal action. It is important that the form is as comprehensive as possible as this will allow the doctor to get a good idea of your (the patient’s) health risks and overall health. So what does a history form include? Let’s find out.

What’s included in the form?

It is important that the history form reveals health information and conditions specific to the individual patient. Also, there should be room for updating it on an annual basis or when deemed necessary. A printable medical history form template can give you a good idea about what’s included in the form. However, to give a head start, here are some of things that the history form must include:

  • The form should reveal the patient’s diet, injuries, current medications, allergies, systemic diseases, current treatment, surgeries, herbal supplements, and reaction to anesthetics
  • The form must include the name and contact information of the patient’s physician. Both the patient and the physician must sign this part of the form
  • The form should have a section that includes the follow up remarks from the physician
  • The form must have a ‘progress notes’ section in which all updates and changes are noted
  • The form should allow the patient to respond to questions with a simple yes/no.
  • To ensure that the patient does not overlook important health considerations, the form should have a medical alert sticker, label, notation, or any other thing that garners attention

Who should complete the form?

This is question people often ask. A documented medical history is something that all patients of a hospital/clinic must have. A document medical history of a person is obtained through a history form. So, who needs to complete this form? Adults are required to fill out their form themselves while the forms of minor children must be completed by their parents, grandparents or other legal guardians.

Now, if they want, doctors can mail the aforementioned form to the patients before their appointments. The printable medical history form mailed to the patients can be easily printed out and completed. Patients can also choose to complete the form at the hospital/ doctor’s office. Regardless of how they fill the form, patients often have difficulty completing it. Usually, the doctor’s assistant or other medical staff helps the patient to complete all sections of the form. Also, the health conditions of the patient that the doctor must know about are highlighted in yellow or another color.

When should the form be completed and updated?

As mentioned above, patients can choose to complete the form at their home or office before the appointment with the doctor. Also, prior to treatment, it is important for emergency patients to provide their complete medical history using the form. Also, people who’ve filled out the form in the past and are repeat patients should update their form at least once a year or whenever there is a change in their health condition.

Personal Medical History Form

Creating the form

In order to complete your history form, you must gather all your medical records such as your medications, recent illnesses, recent visits to your doctor and hospitalizations. This is the minimum information that your medical history form should include. In addition to the aforementioned information, the form should include your DOB, diagnostic tests, recent health screenings, blood type, information about chronic illnesses and allergies to food and medicines.

After you have all of the aforementioned information with you, choose a medium for creating the medical history. As long as it is portable, secure, and accessible in an emergency, you can choose any format that you like. You can choose a spreadsheet or a spiral notebook or binder. The choice is yours.

To allow the doctor who’s treating you to get a good idea of your overall health, include as much information as possible in the medical history. You can even provide a summary of your lifestyle habits such as whether you exercise regularly, smoke, or have gained/lost weight recently. Another wise thing to do is including the names and contact information of your current medical care providers and the people to contact in case of an emergency. Also, if your insurance covers healthcare expenses, provide the name and contact info of your health insurance provider. To get a better understanding of this, you can take a look at a medical history form template.

Family medical history form

Even if you don’t currently have any health problems, your family health history will give you a good idea about your own and your family’s future health. Your family health history will allow you to know whether certain diseases and health conditions run in your family. You may feel uncomfortable asking family members about their health problems but doing so is important. Provided you assembled it appropriately, your family health history can help do the following things:

  • Identify whether you have a high risk for a particular disease
  • Help your doctor or other medical care provider to recommend you treatments/ways to reduce your risk for the disease
  • Give you information about the early warning signs of the disease
  • Help plan lifestyle changes that can keep you healthy

A lifetime record, family health history should be provided by patients to all their new physicians receiving medical care. Following are the things that a family medical history should include:

  • Immediate and distant relatives
  • The age of all the relatives
  • The ethnicity of all relatives
  • The presence of chronic diseases

emergency contact form

A well-established way to identify genetic disorders and vulnerabilities, family health history is a good way to discern a person’s risk for future health problems. One of the best ways to identify people at risk for inheritable disorders, the use of a family medical history form is crucial. The most basic type of family medical history form will ask you questions about you, your parents, your siblings, and your grandparents. So, before you fill out the family history form, gather all the relevant information about you, your parents, your siblings, and your grandparents.

Today, doctors determine suitable treatments/medications for patients using their medical forms. Talking about medical forms, one of the most important medical forms in use today is the medical history form. This form gives doctors a good idea about your health conditions and your medications/treatments.

General Medical History Form

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