Get Please Fill Out This Form And Bring It To The Appointment - Mydoctor Kaiserpermanente

Filling out the 'Please Fill Out This Form And Bring It To The Appointment - Mydoctor Kaiserpermanente' form online is a straightforward process that ensures you are prepared for your upcoming medical appointment. This guide will walk you through each section of the form, providing clear instructions to make the experience seamless and efficient.

Follow the steps to easily complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your name in the designated field. This is important for identification purposes during your appointment.
3. Next, fill in your medical record number (MR#) if available. This number helps the medical staff access your history quickly.
4. In the 'Historial Confidencial Del Paciente' section, describe your pain by selecting either 'Continuo' (continuous) or 'Intermitente' (intermittent). This information assists your healthcare provider in understanding your condition.
5. Indicate the approximate date when your pain started by writing the date in the provided space. This helps in tracking the duration of your discomfort.
6. Rate your pain over the last two weeks using the scale provided. Mark an 'X' in the appropriate box between 0 (no pain) and 10 (worst possible pain). Repeat this for your current pain level.
7. Use the symbols provided in the diagram to indicate experiences such as numbness or tingling, as well as the type of pain you are experiencing.
8. Classify various activities according to how they affect your pain by checking the boxes for 'Mejor' (better), 'Peor' (worse), or 'No hay cambio' (no change) for each activity listed.
9. List any past surgeries along with their dates in the designated space to keep your medical history accurate and complete.
10. Indicate your current employment status by checking one of the options: 'Trabajando' (working), 'Jubilado' (retired), or 'Discapacitado' (disabled).
11. Lastly, review all the information you have inputted for accuracy. Once confirmed, save your changes, and you may choose to download, print, or share the form as needed.

Complete your document online today to ensure a smooth appointment experience.