Get St. Joseph Medical Group Patient Interval History & Physical Form

Completing the St. Joseph Medical Group Patient Interval History & Physical Form is an essential step in ensuring accurate medical history and effective care. This guide provides clear instructions on how to fill out the form online, making the process straightforward and efficient.

Follow the steps to fill out the form online easily.

1. Press the ‘Get Form’ button to access the Patient Interval History & Physical Form and open it in your preferred digital format.
2. Begin by entering the date at the top of the form, followed by your full name and chart number.
3. Fill in your contact details, including home, work, and cell phone numbers.
4. Provide details regarding your pregnancy history, including the total number of pregnancies and any miscarriages.
5. Enter the name of your primary care physician and your insurance information.
6. Indicate your date of birth and your current age.
7. If applicable, provide information regarding your current method of birth control and whether you have undergone tubal ligation or vasectomy.
8. Record the date of your last menstrual period and details of your menstrual cycle, including frequency and duration.
9. Answer questions related to any unusual vaginal discharge, bleeding, or menstrual irregularities.
10. Address inquiries about smoking, recreational drug use, alcohol consumption, caffeine intake, and exercise frequency.
11. List any known allergies to medications or materials and provide a detailed list of all medications, vitamins, and supplements you take.
12. Indicate whether you have experienced any major surgeries or diagnosed medical conditions since your last visit.
13. Complete the family medical history section by noting any new diagnoses of relevant conditions.
14. If applicable, confirm if you or your mother took the synthetic estrogen DES and whether you have received the pneumococcal vaccine if over 65.
15. Once all sections are filled out, review your information for accuracy before saving, downloading, printing, or sharing the completed form.

Start filling out the St. Joseph Medical Group Patient Interval History & Physical Form online today.