Get Sharp Grossmont Hospital Shc-nu-3424-ns 2010-2025

This guide provides a step-by-step approach to filling out the Sharp Grossmont Hospital SHC-NU-3424-NS form online. You will find detailed instructions for each section to ensure accurate and complete submission.

Follow the steps to successfully complete the form:

1. Press the ‘Get Form’ button to access the document and open it in your editing tool.
2. Fill in the section labeled 'General Information' with the patient’s full name, date of birth, and preferred name. Provide the name of the person who completed the form.
3. Indicate whether the patient has been hospitalized in the past 30 days, and if so, specify when and where.
4. Complete the emergency contact section with the name and phone number of a designated contact.
5. Describe the reason for the visit in the corresponding field.
6. Provide the name of the primary doctor and the date of the last exam or tests.
7. Answer the questions regarding health concerns, allergies, and interpreter needs by selecting 'Yes' or 'No' where applicable. Fill in additional details as required.
8. Complete the medical history section by checking any of the relevant conditions that apply to the patient.
9. If applicable, answer the diabetes-related questions and provide fasting blood glucose levels and last HgbA1c results.
10. Review the cardiac/anesthesia status questions and list any relevant tests or history.
11. Include any previous surgeries and procedures in the designated area.
12. For female patients, indicate the possibility of pregnancy and provide the date of the last menstrual period.
13. Review all entered information for accuracy and completeness before proceeding.
14. After completing the form, you can choose to save changes, download, print, or share it as needed.

Complete your documents online for a smooth experience.