Get Urology Patient History Form - Cmhshealth

Completing the Urology Patient History Form - Cmhshealth online is an essential step in providing your healthcare provider with vital information. This comprehensive guide will walk you through each section of the form to ensure accuracy and thoroughness.

Follow the steps to complete your Urology Patient History Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in the 'Referred by' section with the name of the healthcare professional who referred you. This information may assist in your treatment process.
3. Indicate your marital status by selecting from the options provided: Married, Divorced, Widowed, or Single.
4. Next, describe your main symptom(s) at present. Be as specific as possible to help your provider understand your condition.
5. Fill in the number of children you have in the designated field.
6. In the Urologic History section, answer each question regarding past urinary issues by selecting 'Yes' or 'No' as applicable.
7. Move on to the Past Medical History section. Circle the conditions you have or have had from the list provided. Be thorough to ensure no medical history is overlooked.
8. Indicate any previous injuries or hospitalizations you have experienced, including details if relevant.
9. If applicable, specify the number of pregnancies you have had in the section provided.
10. Answer if you have had a recent cardiogram or chest x-ray as this information may be crucial for your healthcare provider.
11. Detail your habits regarding tobacco, alcohol, coffee, or other substances in the designated field.
12. Finally, provide information about your family history by indicating any relatives who have had mentioned diseases such as diabetes, kidney stones, tuberculosis, and heart disease.
13. Once all sections of the form are completed, make sure to save your changes, and you may also choose to download, print, or share the form as needed.

Start completing your Urology Patient History Form online today for efficient and accurate healthcare management.