Free Physical Examination Form

Physical Examination Form
Please provide all the necessary information below to complete this form.
Patient Information
Name
Date of Birth
Gender
Male
Female
Date of Exam
Medical History
Known Allergies
Current Medications
Past Medical Conditions
Family Medical History
Vital Signs
Height
Weight
Blood Pressure
Heart Rate
Respiratory Rate
Temperature
Alertness and Orientation
Skin Condition
Systemic Examination
Head, Eyes, Ears, Nose, Throat (HEENT)
Observations:
Cardiovascular System
Heart sounds, murmurs, etc.:
Respiratory System
Lung sounds, abnormalities:
Abdominal Examination
Tenderness, masses, etc.
Musculoskeletal System
Joint pain, range of motion
Neurological Examination
Assessment & Plan
Assessment Summary
Recommended Tests
Treatment Plan
Follow-Up Date
Physician's Information
Physician's Name
License Number
Date:
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Streamline your medical assessments with our Physical Examination Form Template, designed to make patient evaluations efficient and thorough. Easily customizable with our AI Editor Tool, this template ensures a structured approach for recording vital health data. Perfect for healthcare professionals aiming to enhance accuracy and save time, this template is your go-to for reliable physica