Get Gastroenterology Associates Patient Interview Form 2015-2025

Completing the Gastroenterology Associates Patient Interview Form online is an important step for your medical evaluation. This guide will take you through each section of the form to ensure that you provide all the necessary information clearly and accurately.

Follow the steps to successfully complete the patient interview form.

1. Click ‘Get Form’ button to obtain the form and open it in the editing tool.
2. Begin with the 'Patient Information' section. Fill in your first name, last name, medical record number (MRN), date of birth, age, and any relevant notes.
3. In the 'Contact Preference' section, choose how you prefer to be contacted for communications by selecting either email, telephone call/leave message, or the option to decline specification.
4. Next, proceed to the 'Allergies' section. Indicate if you have no known allergies, or check any relevant allergies from the provided list, including specific drugs and substances.
5. In the 'Past or Present Medical Conditions' section, select any conditions that apply to you from the extensive list provided. If 'none' applies, ensure that this option is checked.
6. Continue to the 'Diagnostic Studies/Tests' section where you can indicate any relevant gastrointestinal tests you have undergone. If none apply, choose that option.
7. Fill out the 'Previous Procedures' section by detailing any past surgeries or medical procedures you've had, choosing the appropriate options from the listed types.
8. Next, complete the 'Family Medical History' section by providing information about any known family medical conditions.
9. In the 'Social History' section, provide your occupation, number of children, marital status, and details about alcohol and tobacco use, being as specific as possible.
10. For the 'Review of Systems' section, respond to the given conditions by indicating if they apply to you or not. Be sure to check each category carefully.
11. Proceed to the 'Pharmacy' section, where you can provide the name, address, and phone number of your pharmacy.
12. List your current medications in the 'Current Medications' section, including the name, dose, and how you take each medication.
13. Consent options are next. Indicate your choices regarding obtaining a medication history, receiving follow-up reminders, and sharing data with other health entities.
14. Finally, sign the form, document the date, and review all information provided for accuracy before submission.

Complete your Gastroenterology Associates Patient Interview Form online today to ensure your health information is documented accurately.