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Table of Contents

  1. 6 Steps to Make Medical History
  2. 23+ Medical History Templates
  3. 1. Medical History Template
  4. 2. Medical History Form in PDF
  5. 3. Medical History Questionnaire
  6. 4. Family Medical History Template
  7. 5. Sample Medical History in PDF
  8. 6. Medical History for Foreign Service
  9. 7. Report of Medical History Template
  10. 8. Physical Medical History Template
  11. 9. Medical History Form Template
  12. 10. Medical History Form in PDF
  13. 11. Medical History Questionnaire Template
  14. 12. Medical History Questionnaire Example
  15. 13. Patient Medical History Form Template
  16. 14. Contractors Medical History Form
  17. 15. Diving Medical History Form Template
  18. 16. Report of Medical History
  19. 17. Simple Medical History Form
  20. 18. Birth Parent Updated Medical History
  21. 19. Access Claims Medical History Template
  22. 20. Family Medical History Template
  23. 21. Athletes Medical History template
  24. 22. Significant Medical History Template
  25. 23. Medical Office Health History Form
  26. 24. History of Past Medical Problems

23+ Medical History Templates in PDF | DOC

A medical history or health history report is prepared by the doctors on a person’s three generations. The preceding and succeeding ones. Because family members have different sort of similarities between genes and lifestyle. And if one generation has suffered any disease the next or the grandchild of that family is also vulnerable to getting that disease. That is why a medical history is required to keep notice of the several medical conditions and take actions on it. We have structure several medical history templates that you might like. Have a look at them.

6 Steps to Make Medical History

Step 1: Patient’s Details

The medical history report should start by specifying the identity, DOB of the patient. It should also ask the patient is he or she has donated anything or any part of their body. If yes ask them to detail it. It should also ask the patients to specify their current medical condition and problems.

Step 2: Family History

The family history on the medical report should ask details of at least the immediate family members if not all the three generations. It should add all type of disease and addiction details, any old allergies or surgery details.

Step 3: Social History

The social history in a medical history report needs to add if the patient has any sort of tobacco, alcohol or caffeine addiction. And it should also involve the marital and living status of the patient.

Step 4: Women’s Health History

If the patient is a woman a different column is required to gather some more specific information. The history sheet should ask information on their period cycle, their children’s birth method and pregnancy status. It should also include the menopause status and consumption of contraceptive pills.

Step 5: Current Medication

After asking all the questions on the medical health of the patient you might ask them to fill in the detail of the medication they are going through. The history sheet should be having an apt space so that the patient can fill all the medicine details.

Step 6: Depression Check

The medical history sheet should also ask two or three pointed questions to the patients. The answer to the questions can help you to analyze is he or she is suffering from depression too so that you can act upon that too.

23+ Medical History Templates

1. Medical History Template

medical history templatengpg.org
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  • PDF

Size: 227 KB

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A medical history form is prepared by the medical experts to record and evaluate the medical condition of the patient and their family members. It also helps the doctors to understand that who from your family are more vulnerable to a certain diseases. If you are also running a medical service and need to have a finely designed history sheet, you can choose this medical template. This form is designed in such a way that it can frame different information about the patients and their relatives.

2. Medical History Form in PDF

medical history formsimonsendental.com
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  • PDF

Size: 564 KB

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We understand running a medical service organization might not be easy. You might need to face different challenges each day. That is why we suggest you choose this medical history report and reduce your workload. You can offer this form to the patients suffering from serious diseases too as it is designed highlighting both major and minor health details. So grab this template today!

3. Medical History Questionnaire

medical history questionnairempfcak.com
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  • PDF

Size: 186 KB

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If you are facing several different or new diseases of your patients every day it is better to keep their medical record framed minutely. If you need to have a proper document to have that record you can choose this questionnaire template. This minutely designed medical history questionnaire has highlighted different medical status and aspects that you can use to let your patients specify their conditions.

4. Family Medical History Template

know your family medical historyfacingourrisk.org
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  • PDF

Size: 89 KB

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If you are running medical consultancy services this template might be helpful to you. Apart from giving medical guidance to your patients, you can also ask them to fill this family medical history form. This family history form can help you to guide them from observing their past family medical status. You can also have a look at the criteria that the form highlights before downloading this template.

5. Sample Medical History in PDF

sample medical historymapleridgedental.com
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  • PDF

Size: 662 KB

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If you are framing medical history forms for your patients, wait for a second and have a look at this frame. This template in PDF format is designed stressing different types of diseases, allergies, addiction, surgery specifications in it. Choosing this template you can offer this form to several patients suffering from different diseases as it covers all. So hurry to grab this template today!

6. Medical History for Foreign Service

medical history and examination for foreign serviceeforms.state.gov

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  • PDF

Size: 82 KB

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If you need to have medical forms for providing foreign services on medical history, you can choose this template. Designed in a formal structure this template starts with an instructive note on the privacy notice and a statement. It tries to cover different health issues of people aged 12 or more than that. Choose this editable template if it seems to suit your project or medical history purpose.

7. Report of Medical History Template

report of medical history templategsa.gov
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  • PDF

Size: 347 KB

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Different organizations or firms might like to use different sorts of history sheets for recording the medical details of the patients. If you are also looking for a readymade different structure, you can have a look at this template once. This template is designed specifying different health conditions and status of the patient along with their immediate family members’.

8. Physical Medical History Template

participation physical medical historyuiltexas.org
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  • PDF

Size: 312 KB

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If you are operating physician services and you want your patients to get more effective services from your ends you should look at this template. This template designed specifically to record the physical health of the patients records different medical conditions minutely. Check out this frame if it can help you to structure the aspects that you want to frame in your medical history form.

9. Medical History Form Template

medical history form templatenacc.edu
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  • PDF

Size: 113 KB

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Different organization follows different formats for designing the medical history form. It also depends on the services you ate serving patients with. If you are framing a simple medical history form this sample might be perfect for that. Taking every important aspect in the frame this template has specified different medical conditions in a PDF file. Check out its aspects or you can also check out our medical release forms.

10. Medical History Form in PDF

zero experience medical history formgozerog.com
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  • PDF

Size: 59 KB

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If you want to have a check on your patients if they are in a proper condition to be provided with certain medication choose this template. This template would also let you know how to process with the patient without hindering their prior condition. So try this form today to reduce your workloads. You can easily print and provide this template to different patients or you can also check out our medical certificate in PDF templates.

11. Medical History Questionnaire Template

medical history questionnaire templateincome.com.sg
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  • PDF

Size: 486 KB

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Not every institution or medical organization might like to have a form for recording medical condition and history. Thus we have managed to offer you this form in a questionnaire format that you might try to record the medical status of the patients. The questionnaire provides an apt space to the patients to specify what they are suffering from in their words. You can also have a look at our medical chart templates for more options.

12. Medical History Questionnaire Example

medical history questionnaire examplemsecnd.net
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  • PDF

Size: 51 KB

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If you require a medical history form for collecting information about patients and the embedded casues of the disease choose this template. Designed in the form of the questionnaire this template asks both the close-ended and open-ended question to collect the information. You can download and print the template to circulate it to your patients to have knowledge of their medical history and status. We can also help you to frame medical certificate templates for your patients. Have a look at them.

13. Patient Medical History Form Template

patient medical history formflcancer.com

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  • PDF

Size: 303 KB

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If you require a simple frame of the document that can record your patient’s medical history we suggest you choose this template. Designed in simple structure this template focuses to frame the patient’s medical status and history. We also have templates available on psychiatric history for you that you may try and use for your purposes. Check out this file if it can fulfill your purpose.

14. Contractors Medical History Form

contractors medical history formadc-int.org
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  • PDF

Size: 139 KB

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We have tried to make different sorts of medical history forms available for you. The given sample of the template is one of those. If you feel that your organization might need a contractor’s medical history form you might choose this template. This template is designed after studying the needs of several medical conditions that a history sheet should contain. Similarly, we have also retained some pediatric history forms that you might like to use. Check them out.

15. Diving Medical History Form Template

diving medical history formbu.edu
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  • PDF

Size: 167 KB

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A diving medical history form might need to cover several specification that need to be checked and verified by the expert. If you are offering such a service you should prepare a proper document on it to record the details. Or you can refer to this template that has framed almost all the important conditions that your patient might need or you would want to ask.

16. Report of Medical History

report of medical historyesd.whs.mil
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File Format
  • PDF

Size: 418 KB

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Preparing a report out of calculating the medical history and status of the patient might be confusing at times. That is why we suggest you refer to this structure of template that is a proper frame of the report of medical history. If you need anything on timelining the medical processes we have some templates on medical timelines that you might try.

17. Simple Medical History Form

simple medical history formstangelsrohini.com
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  • PDF

Size: 133 KB

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18. Birth Parent Updated Medical History

birth parent updated medical historymaine.gov
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File Format
  • PDF

Size: 389 KB

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19. Access Claims Medical History Template

access claims based medical historymedicaidprovider.mt.gov
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  • PDF

Size: 28KB

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20. Family Medical History Template

your family medical historyhealthlinkbc.c
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File Format
  • PDF

Size: 149 KB

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21. Athletes Medical History template

athletes medical history templatemchenry.edu
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  • PDF

Size: 19 KB

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22. Significant Medical History Template

significant medical history templateimpact.org
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  • PDF

Size: 19 KB

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23. Medical Office Health History Form

medical office health history form templatehosa.org
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File Format
  • PDF

Size: 71 KB

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24. History of Past Medical Problems

history of past medical problemsed.virginia.edu

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File Format

  • DOC

Size: 11 KB

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