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MultiCare History Intake Form Patient Name: Nickname: Date of Birth: Today's Date: Allergies (List name and reaction) Medications/Drugs: Type of reaction Food / Environmental Medication List Type.

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How to fill out the Multicare Mychart online

Filling out the Multicare Mychart online is a convenient way to provide important medical information. This guide will walk you through each section of the form, ensuring you complete it accurately and effectively.

Follow the steps to complete the Multicare Mychart form.

  1. Click the ‘Get Form’ button to access the Multicare Mychart document and open it for completion.
  2. Begin by entering your personal details at the top of the form. Fill in your patient name, nickname, date of birth, and today’s date.
  3. Next, provide information about any allergies you have. List the name of the allergen and describe your reaction for each.
  4. Detail any medications you are currently taking, including both prescription and non-prescription drugs, as well as vitamins and herbal supplements. For each medication, include the name, dosage, and frequency taken per day.
  5. In the surgical procedures or hospitalizations section, list any past surgeries or hospital visits, including the type and date.
  6. Move on to the medical history section. Check all relevant medical conditions that apply to you from the provided list.
  7. Proceed to the family history section. Indicate whether you are adopted and check any familial conditions that are applicable across your family members.
  8. Complete the social history section by listing all persons living in your household and detailing your marital status and substance use habits.
  9. If applicable, fill out the section for female patients regarding menstruation and pregnancy history.
  10. Finally, review all entered information for accuracy. You can then save changes, download, print, or share the completed form.

Complete your Multicare Mychart online form today for a smoother healthcare experience.

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