Medical History Form

What is a Medical History Form?

A medical history form is used to collect information about a patient’s medical history. Past medical history includes information such as the patient’s past surgical history, family medical history, social history, allergies, and medications the patient is taking or may have recently stopped taking.

All diseases and illnesses which are currently being treated are also included in the medical history form, a surgical history is needed to understand all the invasive procedures that have been done on the patient, Family history is needed to understand if the patient has genetic predisposition to any diseases.

Social history includes information around the patient’s habits that may directly impact their health. For example, smoking, alcohol or substance abuse are habits that can have a significant effect on a patient’s health. It may also include other  aspects of the patient’s health including spiritual, mental, relationship status, occupation, hobbies, and sexual activity or pertinent sexual habits.

Why is a Medical History Form Needed?

A medical history form is pertinent because it will help the medical practitioner to accurately prescribe treatment to the patient based on the medical history. Missing any detail about the medical history could potentially disrupt any treatment procedure and render it ineffective or even prove fatal.

In short, a medical history form will allow the medical practitioner to curate the best possible treatment for their patients, while accounting for prevailing medical conditions, allergies, medications etc.

Who Fills the Medical History Form?

The medical history form is usually filled out by the patient themselves. In case the patient is a minor, their legal guardian can also fill their medical history form.