Follow the steps to complete your Historial Médico accurately.

1. Click ‘Get Form’ button to access the Historial Médico and open it for editing.
2. Begin by entering your full name in the 'Nombre' field, followed by the date and your date of birth in the respective fields.
3. Next, fill in the name of your primary care physician in the 'Médico de atención Primaria' section.
4. In the 'Razón por su visita' field, briefly describe the reason for your visit.
5. List all medications you are currently taking, including prescribed and over-the-counter drugs, along with their dosage, quantity, and frequency of intake in the medication section.
6. For your medical history, mark the conditions you currently have or have had in the past by checking the appropriate box next to each listed condition.
7. Complete the allergy section by indicating whether you are allergic to latex and describe the reaction if applicable.
8. In the gynecological history section, provide details such as the age you began menstruating, dates of your last menstrual period, Pap smear, and mammogram along with their results.
9. Document your obstetric history by writing down each pregnancy you have had, indicating if it was a natural birth, cesarean, or abortion, along with the date and any complications.
10. In the surgical and hospitalizations section, specify the month and year of any surgeries you have had and the type or reason for hospitalization.
11. Fill in the family medical history by providing details about health concerns such as cancer, diabetes, and heart disease among family members, including their relationship to you, age, health status, and age at death if applicable.
12. Complete the social history section noting whether you use tobacco, alcohol, or illegal drugs, and include details on usage frequency and interest in cessation.
13. In the immunizations section, indicate which vaccinations you have received, including hepatitis B, flu vaccine, pneumonia vaccine, and tetanus.

Complete your Historial Médico online today to ensure your health information is up-to-date.