Get General Health Questionnaire 7-27-09 Version.doc. Hipaa Privacy Release Form

This guide provides clear and supportive instructions for filling out the General Health Questionnaire and HIPAA Privacy Release Form online. Following these steps will help ensure that all necessary information is accurately submitted, aiding in the processing of your application.

Follow the steps to complete the form successfully:

1. Click the ‘Get Form’ button to access the document and open it in your preferred editor for online completion.
2. Begin by filling in the name of the primary applicant and their ID or social security number in the designated fields.
3. Next, enter the patient’s name clearly in the specified section.
4. Provide the name of the physician who will fill out the form, ensuring accurate and clear printing.
5. Indicate the current height of the patient in feet and inches.
6. Record the patient’s current weight in pounds, specifying whether this weight is with or without shoes.
7. Enter the patient’s blood pressure readings from the office visit.
8. Respond to the question regarding any abnormal lab results from the last five years. If applicable, indicate whether copies of these results are attached.
9. If applicable, detail any symptoms the patient has experienced that have not been checked by a physician and provide information about any planned follow-up.
10. Provide the physician's address and phone number, ensuring all details are printed clearly.
11. The physician must sign the form and date it accurately before submission.
12. Finally, review all the entered information for accuracy, then save your changes, download, print, or share the completed form as needed.

Complete your documents online to ensure a smooth application process.