Get Medical History & Physical Exam Update Form

Filling out the medical history & physical exam update form accurately is essential for maintaining your health records. This guide will assist you in completing the form online, ensuring that your medical information is up-to-date and comprehensive.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your last name, first name, and student ID in the appropriate fields at the top of the form.
3. Proceed to the 'Annual Update of Review of Systems / Medical History' section. Carefully check all items that apply to your current health status, including any medical conditions, allergies, or recent surgeries.
4. For the Mantoux PPD test, provide details such as the date administered, administered by, manufacturer, expiration date, lot number, and date & time read. If results are positive, complete the additional fields with necessary information.
5. Address the influenza virus vaccine section by entering the vaccination provider, injection date, and the provider's signature.
6. Fill in the medical history and physical examination section as requested. The examiner will need to examine and note findings such as height, weight, and blood pressure, along with their comments on each health system.
7. Indicate any current medications, participation limitations in physical activities, or required health supervision, as applicable.
8. Make sure to provide the examiner's details, including their name, contact number, address, and signature.
9. Once you have completed all sections, review the entire form for accuracy. After confirming all information is correct, you can save changes, download, print, or share the form as needed.

Complete your medical history & physical exam update form online today to ensure your health records stay current.