Get Csc Health History Form - Columbia Skin Clinic

Filling out the CSC Health History Form is an essential step in ensuring safe and effective electrology treatments at Columbia Skin Clinic. This guide will provide you with clear, step-by-step instructions on how to accurately complete the form online.

Follow the steps to complete your health history form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal information, including your name, date, phone numbers, address, email address, birth date, and sex. Ensure that all details are accurate, as this information is crucial for your treatment.
3. Provide instructions for calling or leaving a message if necessary, as well as the name of the person who referred you and their phone number.
4. In the Electrolysis section, circle the areas you wish to have treated. This includes facial and body areas. Be sure to specify if hair growth in noted areas was sudden or gradual.
5. Complete the Family History section by noting any female blood relatives with similar hair growth patterns and answer questions regarding previous electrology treatments, if applicable.
6. Fill out the Medical Information section by providing details about your family physician, gynecologist, and dermatologist, including their contact numbers. Also, indicate the last exam date by these practitioners.
7. Describe any pre-existing skin conditions you may have, along with any recent skin infections or problems. This helps the electrologist understand your skin's current health.
8. Indicate any allergies you might have, specifying cosmetics, medicines, and other substances.
9. List any current medications you are taking, including hormonal treatments or birth control pills.
10. Complete the Menstrual History section, providing details about your cycle, any history of menstruation irregularities, and any relevant surgeries like hysterectomy.
11. Acknowledge the understanding of the health history importance by signing and dating the form. If applicable, a parent or guardian should also sign.
12. Review all your entries for accuracy. After finishing, you can save your changes, download a copy for your records, print it if needed, or share it with your healthcare provider.

Take the first step towards your treatment by completing the CSC Health History Form online today.