Get Patient Questionaire - Dr. Laurel White

Completing the Patient Questionnaire for Dr. Laurel White online is an important step in ensuring comprehensive care during your pregnancy. This guide provides clear instructions to help you navigate each section of the form with ease.

Follow the steps to complete the questionnaire effectively.

1. Press the ‘Get Form’ button to access the Patient Questionnaire and open it in your preferred online editor.
2. Begin by entering your name, birth date, age, and occupation in the designated fields. This information helps the medical team understand your demographic background.
3. Provide your ethnic origin along with the name and details of your medical provider, either your MD or midwife, to ensure your records are accurately updated.
4. Indicate the father of the baby by filling in their name, birth date, age, and occupation, as well as their ethnic origin.
5. Describe the reason for your visit in the provided section to assist in triaging your needs effectively.
6. Document the date of your last menstrual period and your expected due date, along with your height and weight at the time of conception to provide essential health metrics.
7. Respond to the questions regarding difficulties conceiving and related medical interventions you have experienced, marking 'Yes' or 'No' as appropriate.
8. Provide information about any pregnancy complications, your ultrasound history, and any genetic testing conducted.
9. List all current medications you are taking and detail your menstrual history and exposure to substances such as alcohol or tobacco.
10. Fill out your obstetric history, indicating how many pregnancies you have had, your living children count, and any past pregnancy complications.
11. Complete the social history section by detailing your living arrangements, exercise habits, and any recent accidents or experiences of violence.
12. Document your past medical history, listing any medical issues you've had, their diagnoses, and any relevant surgeries.
13. Answer questions regarding the medical history of the baby's father and family ancestry to provide a comprehensive health background.
14. Review all provided information for accuracy before deciding whether to save changes, download, print, or share the filled form.

Complete the Patient Questionnaire online to help facilitate your care.