Medical and Surgical History Form

A patient either in outpatient or in-patient department undergoes an uncountable number of questions from his presenting complaints to his past history of ailments and drug intake. These questions are really important to know because a doctor is very much interested in knowing the detail of each and everything that happened to his health in any form.

Why Past history is asked and maintained in the form?

But why does a doctor want to know the history? One may ask this question especially if he is coming to the hospital for apparently a very trivial reason. The answer to this question is very simple yet it can take lengths to complete. The reasons can be explained in the following paragraphs.

  • Medication history

When you are asked if you are currently taking any medicine for any specific illness or reason, he wants to know because many drugs when together may interact and prove harmful. So, by any means, if you are taking any drugs and the drugs doctor is going to prescribe may interact with that, he will need to change the medicine or change the regime or routine.  


If you are allergic to certain chemicals or drugs, he will avoid using them on you and will notify it to the other health professionals as well.

  • Medical History

It is an undeniably important question in the history taking process. A patient is asked about his current and past medical illnesses and wants to know the nature of his present complaints and find out any association with the past.

This is again a very important part of the history taking and ignoring or forgetting this is no less than a crime. A person can be allergic to a drug which is likely to be prescribed leading to a life-threatening situation rather than life-saving. Allergy to blood transfusion is also important to ask.

A person with known systemic diseases is very important to know like diabetes, hypertension, cardiac, respiratory and renal diseases because it changes the overall management plan of the patient. Similarly, past medical history in the family is also inquired because even if the patient is not currently suffering from them, he still has higher chances of developing them than other population.

  • Surgical History

Surgical History is important for the same reasons. If a person has to undergo another surgery, his doctor knows already what he has undergone in the past and what should he expect from his future expected surgery. What careful measures are to be taken this time to avoid possible complication and how did the process of anesthesia go in the past.

  • History of Allergies

All the above reasons make it mandatory for a health professional to ask about past medical, surgical, medication and allergy history religiously. There is no excuse for these actions and the patients must also cooperate with their doctors in this regard.

After all, we come to the hospital for a complete and reliable treatment rather than a hit and trial and bad outcome with respect to our health.

Sample form

Medical and surgical history form
Provided by:

Simi Karton

Simi Karton is a regular contributor to National Science Quarterly and an enthusiastic Lakers fan. She recently collaborated on a manuscript with friends and colleagues. Dr. Simi Karton, entitled Parkinsons and the Genetic Response to Eastern Medicine, in which she and Dr. Inshal presented research compiled during a summer spent in United States. She currently resides in Los Angeles with her husband. This website is a voluntary work of Dr. Karton to provide people with useful health related information stuff at an easy approach. The information has been collected from different sources at one place.

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