What Is a Medical History Form?

A medical history form may include a list of immunizations.
A patient's family history is typically included in his or her medical history.
Medical history forms help provide doctors with patient information and history of medical attention.
Patients must complete a patient history form before a psychiatrist can start therapy.
Article Details
  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 25 June 2014
  • Copyright Protected:
    Conjecture Corporation
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A medical history form is something that doctors help patients fill out or ask them to fill out, often as part of being a new patient. Forms like these can be used in other contexts, including by insurance companies to judge the insurability of people for either life or medical insurance. In this context, they are usually not very helpful to people who want insurance, since information gathered may be used to raise prices or deny coverage. As originally intended, they are of use to people because they give doctors valuable information about patient history, risk factors, and care requirements.

Each medical history form can be slightly different. Some are specific to certain types of medicine. For instance, some forms used by psychiatrists have lengthy and intensive questioning on psychiatric issues and might include questions about hearing voices, degree of anxiety or depression, or family history of mental disorders.


For general practice uses, doctors tend to want a medical history form that will give a broad history of the patient’s health and the health of those related to the patient. Many questions require yes/no or check/no check responses. A question might start in the following manner: “Do you or anyone in you family have a history of:” and this would be followed by a list of conditions such as heart disease, high blood pressure, liver disease, thyroid disorder, cancer, etc. People would mark the illnesses with which they have a history or family history, and they might need to fill this out more in depth by specifying family members that have had these illnesses.

In addition to getting a checklist of potential disease risk factors, there are other things a medical history form typically has questions about. Women may need to give details about past pregnancies, miscarriages or abortions. Both genders are likely to have to claim whether or not they smoke, and possibly any recent history of drug use. One question that is vital on the form has to do with allergies, particularly drug allergies. Doctors use this information to make certain they don’t prescribe anything to which a patient might be allergic.

One part of the medical history form that may be challenging to fill out is a present list of drugs. If people take a lot of medicines, it’s a good idea to write them down prior to heading to a new doctor’s office. Write down not only what the medicine is, but the amounts and dosage, and it’s advised people also include any over the counter medications or herbs they take, as these may counteract with newly prescribed drugs.

There are other inquiries that might show up on a medical history form. Questions about sexual practice and safe sex aren’t uncommon. Doctors may ask about exercise frequency or they could be interested in lifestyle choices such as wearing seatbelts. Sometimes there is additional screening for certain illnesses such as depression, and there may be room on the form to list immunizations. Given all the questions, it can often take 10-20 minutes to fill these forms out, and people are advised to get to first appointments with new doctors early so they have the time.

It should be noted that it serves no one to be dishonest on a medical history form, and it can be an extreme disservice to the patient. The more comprehensive these forms, the better the picture a doctor gets of a patient’s total health and health risks. As for the use of such forms in insurance questioning, dishonesty may actually constitute fraud and be a means for a company to deny care or even retroactively refuse to pay on claims, if they granted insurance under false pretenses.


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