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Date MR# Questionario Medico Para Terapia Fisica Nombre Sexo M F Edad Altura Peso Mano dominante R L Ocupacin Lugar de Empleo Historial Medico Cirugas Relevantes o Hospitalizaciones Liste todas sus.

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How to fill out the Questionario Medico online

Filling out the Questionario Medico correctly is crucial for an accurate assessment of your medical needs, especially for physical therapy. This guide will walk you through each section of the form to ensure you provide the necessary information easily and correctly.

Follow the steps to complete the Questionario Medico online.

  1. Click ‘Get Form’ button to access the Questionario Medico and open it in an online editor.
  2. Begin by entering your personal information. Fill in your name, gender, age, height, weight, dominant hand, occupation, and place of employment.
  3. Move on to the medical history section. Note any relevant surgeries or hospitalizations you have experienced. List all current medications and any allergies.
  4. Indicate whether you have recently experienced any of the listed symptoms by checking the appropriate boxes.
  5. In the family history section, check the boxes for any conditions diagnosed in you or your family members.
  6. Answer questions about recent falls, imaging exams received, and describe the onset of your condition.
  7. Rate the severity of your pain on the provided scale. Mark the areas on the body map where you feel pain.
  8. Answer questions about how your symptoms vary, previous treatments, smoking or alcohol use, and any concerns about your living situation.
  9. List any activities you have difficulty with and state your goals for physical therapy.
  10. Finally, select your preferred learning method and provide your signature along with that of a guardian, if applicable.
  11. After completing all sections, review the form for accuracy, then save changes, download, print, or share the form as needed.

Start filling out your Questionario Medico online today for efficient and thorough documentation!

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Related links form

IRS 943 2015 IRS 943 2014 IRS 943 2013 IRS 943 2012

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