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Post on 04-Dec-2019
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LAKEVIEW INTEGRATIVE MEDICINE
PATIENT MEDICAL HISTORY FORM
- BRIEF LIST OF CHIEF COMPLAINTS IN ORDER OF THEIR IMPORTANCE TO YOU.
- BRIEF LIST ALL DIAGNOSIS GIVEN TO YOU CHRONOLOGICALLY, AND YOUR PERSONAL OPINION
ABOUT THE DIAGNOSIS.
- LIST YOUR OPINION ON WHAT YOU THINK HAS HAPPENED TO YOUR HEALTH.
- LIST ALL HEALTH CARE PROVIDERS YOU HAVE CONSULTED, THEIR OPINIONS AND TREATMENT.
- LIST ANY TREATMENT, MEDICATION OR SUPPLEMENTS THAT HAVE IMPROVED YOUR HEALTH.
- LIST CHRONOLOGICALLY ANY MEDICATION YOU HAVE TAKEN IN THE PAST.
- LIST CHRONOLOGICALLY ANY SUGERIES YOU HAVE HAD.
- LIST CHRONOLOGICALLY ANY SIGNIFICANT LABORATORY AND IMAGING RESULTS.
- LIST CHRONOLOGICALLY ANY EXPOSURE TO ENVIRONMENTAL, INDUSTRIAL OR TOXIC
COMPOUNDS.
- LIST ANY HISTORY OF INFECTIONS (EXCLUDE COMMON COLD).
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