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Ntment. Name: Date of birth: Grade in School: Date of examination: Sport(s): Sex assigned at birth (F, M, or intersex): How do you identify your gender? (F, M, or other): List past and current medical conditions: Have you ever had surgery? If yes, list all past surgical procedures: Medicines and supplements: List all current prescriptions, over-the-counter medicines, and supplements (herbal and nutritional):.

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This history should include general questions regarding onset, provoking factors, whether the lesion is painful and how the pain is provoked, the quality of the pain, paresthesias, severity, and onset.

Past medical history (PMH) (including major illnesses, any previous surgery/operations (sometimes distinguished as past surgical history or PSH), any current ongoing illness, e.g. diabetes). Review of systems (ROS) Systematic questioning about different organ systems.

Past Medical and Surgical History All medications should be documented, including prescription medications, over-the-counter drugs, nutraceuticals, supplements, herbs, and vitamins. Drug and food allergies should be noted.

Some of the most common surgical operations done in the United States include the following: Appendectomy. ... Breast biopsy. ... Carotid endarterectomy. ... Cataract surgery. ... Cesarean section (also called a c-section). ... Cholecystectomy. ... Coronary artery bypass. ... Debridement of wound, burn, or infection.

Categories included in past medical history include current health, medications, childhood illnesses, chronic illnesses, acute illnesses, accidents, injuries, and obstetrical health for females.

A procedure to remove or repair a part of the body or to find out whether disease is present. Also called operation.

Which Surgical Procedures Are the Most Dangerous? Brain surgery. One of the most dangerous procedures is any type of surgery on the brain or skull. ... Heart surgery. ... Cancer surgery. ... Transplants. ... Spinal cord surgery. ... What if my doctor made a mistake during my surgery?

A comprehensive history intake includes the patient's medical history, past surgical history, family medical history, social history, allergies, and medications.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232