Get New Patient History Form - Department Of Obstetrics And Gynecology - Columbiaobgyn

Completing the New Patient History Form is an essential step in receiving comprehensive care at the Department of Obstetrics and Gynecology. This guide will help you navigate the online form efficiently, ensuring that all necessary information is accurately submitted.

Follow the steps to successfully fill out the form.

1. Press the ‘Get Form’ button to access the New Patient History Form and open it for editing.
2. Begin by entering your personal information in the designated fields. This includes your name, date of birth, and today's date. Ensure that all details are accurate, as they will be used to identify your medical records.
3. Provide the name of your primary care physician and your preferred pharmacy. This includes their address and phone number, which allows the department to coordinate care with your existing healthcare providers.
4. Indicate the reason for your visit today and the date of your last menstrual period. This information helps the healthcare team understand your current health status.
5. Fill out the medical history section by checking 'yes' or 'no' for various health conditions. If applicable, provide details for any checked items to add clarity to your medical background.
6. In the health maintenance section, list relevant procedures, their dates, and results, such as your last mammogram or colonoscopy.
7. Detail your surgical history, including any procedures you've undergone, and specify if you have had blood transfusions and the dates.
8. List all medications you are taking, including dosages, and any allergies you have to medications or food, including your reactions.
9. Complete the family history section by providing information about your parents and siblings, indicating if they are living or deceased and any relevant medical issues.
10. Answer questions related to your obstetric and gynecological history, including pregnancies and birth details. Provide information about complications, menstrual history, and pap smears.
11. Fill out the social history section, which asks about your occupation, marital status, lifestyle habits, and exercise routine. Be honest for a comprehensive understanding of your health.
12. Review the review of systems section, checking all applicable conditions you may have experienced in the last 6-12 months.
13. After completing all sections, double-check your entries for accuracy. You can then save your changes, download a copy, print the form for your records, or share it with the department as required.

Complete your New Patient History Form online today to ensure you're ready for your visit.