Medical History Questionnaire

You should require your client to complete a comprehensive medical history questionnaire that includes questions concerning personal and family history. 

Use the questionnaire to 

  • Examine the client's record of personal illness, surgeries, and hospitalizations
  • assess previous medical diagnoses and signs and symptoms of disease that have occurred within the past year or are currently present and
  • Analyze your client family history of diabetes, heart disease, stroke, and hypertension.

Download Medical History Questionnaire in Word format 


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