Medical History and Screening Form

Health Issue Questionnaires, History & Screening Forms

A Medical History and Screening Form contain medical information about an individual. As the name implies, the form is in a type of questionnaire. It is filled out by a physician after medical examination of patients. Alternatively, it can also be filled out by individuals on their own based on their physical examination reports or other health assessment forms. However, it should always be signed by a professional practicing physician in order to verify the information provided in the form.

There can be various formats for a medical history and screening form. It depends on the amount of information required which in turn determines the number of questions to be answered. Regardless of the type of format, the form always begins with an individual’s personal data. It is then followed by questions which reveal a person’s health condition. Usually, the questions contained in a medical history form are related to an individual’s family health history, personal medical history and possible allergies. They also cover any other medical problems worth mentioning for the work place or other situations.

A health assessment questionnaire or medical history form can be used in different situations. It can be demanded by employers from their employees in order to carry out a health evaluation of the working staff at any time. On the other hand, it may also be requested by schools to maintain a health record of students. Similarly, several insurance companies also use these forms for their clients. In hospitals, individuals may be asked to fill out this form before being treated for a certain medical problem.


medical history and screening form template

Medical History & Screening Form Template
Microsoft Word document file | File size 46 KB | Download




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.

You may also like...