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T Illness (Why are you here today?): Past Cardiovascular History Disease/Condition Yes Angina Chest Pain Heart Murmur Palpitations Supraventricular Tachycardia (SVT) Atrial Fibrillation Arrhythmia: Type? Loss of Consciousness Heart Attack Heart Disease: Type? Heart Failure: Type? Coronary Artery Disease Peripheral Vascular Disease (PVD) Lipid/ Cholesterol Disorder Type? High Blood Pressure Aneurysm: Type? Edema Stroke/TIA Sleep Apnea No Yes Yes Yes Yes Yes No Yes Yes Yes No No No Yes No.

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Definition: The Patient Information Form (PIF) is used to collect demographic information as well as additional information about the impact of the event on a patient (e.g., level of harm, unplanned interventions). It supplements the HERF in cases where an incident is being reported.

Casual: Short-sleeved collared shirt and jeans with tennis shoes, with or without white coat. Scrubs: Blue short-sleeved scrub top and pants, with or without white coat.

Your cardiac nurse or cardiologist will check your vital signs and perform a physical exam. They may also order a number of tests and diagnostic procedures, depending on your symptoms, risk factors and health history.

You may need to avoid eating in general. 'If your blood work will include a measurement of cholesterol or other fats, it is best to avoid any calories for eight to 10 hours before the test is drawn,' says Dr. Dewar. In general, it's a good idea to hydrate before seeing the doc for a checkup.

This may seem like a short amount of time, but increasing speeds and a 15% incline added to the fact that you can't eat anything for several hours before the test make it more difficult than you'd think.

Don't eat for at least two hours before the exam to keep blood sugar and blood pressure from elevating. Twelve hours of fasting is preferred, so try to schedule your exam in the morning so you can fast overnight.

You will be asked both general health questions and some more specific questions related to the reason for your visit. A physical examination follows, and if necessary the doctor might arrange for further testing. The cardiologist might prescribe medication or provide your primary care provider with recommendations.

A list of your medicines, or the medications themselves. Your pharmacy or primary health care provider can put together this information if you don't have it. ... Family medical history. ... Your own medical history. ... A list of all your health care providers. ... Your own questions.

Please wear loose comfortable clothing (i.e. tee shirt) and shoes. Shorts or slacks are appropriate.

Compile a personal health history and a health history of your family. Gather together any recent test results and a list of medications you are taking. Jot down notes about symptoms you have been experiencing. Make a list of questions you want to ask your doctor.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232