Get Informational Form Jber Patient Health Form Option 2

Filling out the Informational Form JBER Patient Health Form OPTION 2 online is a straightforward process that allows you to provide essential health information necessary for your refractive surgery assessment. This guide will walk you through each section of the form, ensuring you complete it accurately and confidently.

Follow the steps to effectively complete the Informational Form JBER Patient Health Form OPTION 2 online.

1. Click the ‘Get Form’ button to obtain the form and open it in your chosen document editor.
2. Begin with the personal information section. Enter your last name, first name, middle initial, and any suffix. Then, provide your rank, Social Security Number (SSN), date of birth, age, and sex. Specify your military service branch and status.
3. In the occupation section, list your occupation along with your Air Force Specialty Code (AFSC) or Military Occupational Specialty (MOS). Indicate your flying status and date of separation or retirement.
4. Under contact information, fill out your address, unit, and various phone numbers (home, cell, work). Additionally, provide your military email and your commander's email for processing.
5. Complete the medical information section thoroughly. If there are no entries for Drug Allergies, Current Medications, Medical History, or Surgical History, write 'nothing' in each respective field.
6. Indicate any eye conditions or medical conditions you have or have had by selecting 'yes' or 'no' for each item listed, ensuring all sections related to eye conditions and other medical conditions are addressed.
7. If you have ever taken specific medications or treatments, mark the boxes and provide the last date used where indicated. Fill out information regarding contact lens history as required.
8. For the females only section, answer questions regarding pregnancy or nursing statuses.
9. List any hobbies or activities that require special visual requirements, and describe your expectations from the refractive surgery.
10. Affirm the truth of the information provided by signing and dating the form at the bottom.
11. Complete the second page by selecting your preferred language and method of learning, along with any disabilities or barriers, advance directive status, and cultural or religious considerations.
12. Finally, sign the acknowledgment regarding the requirement for follow-up appointments, ensuring your compliance with post-operative directives.
13. After reviewing for accuracy, save your changes, and then download, print, or share the completed form as needed.

Enhance your experience by completing your documents online with ease and confidence.