The FREE gray multi-table Health Care Consumer Questionnaire is a comprehensive medical history form designed to be filled out by the health care consumer prior to a Visit with a health care provider. This MedicalTemplate is appropriate for a new patient evaluation or any visit to a health care provider.
The Health Care Consumer Questionnaire is a detailed 8-page snapshot of an individualâ??s current and past medical problems.
Information included in the colorful table format Health Care Consumer Questionnaire
* Allergies
* Medications
* Surgeries
* Past Medical History
* Family Medical History
* Review of systems
* Social History
* Religious and cultural beliefs
* Travel history
* Occupational history
* Carcinogen Exposure history
* Behavioral risk factors
