Medical History Questionnaire Form In Spanish. If you have a medical condition. Today's date: _ ***Since this is your medical history and it will be used in evaluating your health, it is extremely. important that the questions be answered as accurately and completely as possible.
I hereby state that the questions on this form have been answered completely and truthfully to the best of my knowledge.
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The form has sections for personal health history, health habits and personal safety, family health history, mental health, women only, men only, and other problems. Today's date: _ ***Since this is your medical history and it will be used in evaluating your health, it is extremely. important that the questions be answered as accurately and completely as possible. Translations of the phrase MEDICAL HISTORY from english to spanish: Your medical history , including surgeries and hospitalizations.
