Get Annual Questionnaire - Obgyn Of Lancaster

Filling out the Annual Questionnaire for OBGYN Of Lancaster is a crucial step in ensuring you receive comprehensive care. This guide will provide you with step-by-step instructions to complete the form accurately and efficiently online.

Follow the steps to complete your Annual Questionnaire online.

1. Press the ‘Get Form’ button to download the questionnaire. This action will allow you to access the document for online completion.
2. Begin by entering your medical record number (MRN#) in the designated field. This helps the healthcare provider identify your file and maintain your records accurately.
3. Input your phone numbers, both home and mobile, to ensure that the clinic can reach you if necessary.
4. Provide your full name, age, date of birth (DOB), and the current date. This information is essential for personal identification and demographic review.
5. Indicate the reason for your visit today. This can help direct your care and ensure your needs are met during the appointment.
6. List any current medications and dosages, or check the box for ‘None’ if applicable. This is crucial for understanding your current health management.
7. Record any herbal supplements or over-the-counter medications you are taking, or select ‘None’ if you are not using any.
8. Document your last colonoscopy and mammogram dates in the appropriate fields, as well as any allergy to latex. This is important for your health history.
9. Fill in your medical history by indicating any relevant conditions or checking ‘None’ if there are no concerns. Be thorough.
10. List any surgical history, identifying specific surgeries you have undergone, or check ‘None’ if not applicable.
11. Provide details about your obstetrical history, including previous pregnancies and complications, if any.
12. Complete the gynecologic review of symptoms section, indicating any symptoms that may apply to you.
13. Fill out the social history section, providing details on use of tobacco, alcohol, drugs, and any other relevant lifestyle factors.
14. Enter details about your family history of medical conditions, indicating any significant illnesses among family members.
15. Finally, review all your entries for accuracy, then encourage yourself to save, download, print, or share the completed form as required.

Start completing your Annual Questionnaire - OBGYN Of Lancaster online now to ensure a streamlined health care experience.