How Can You Create a Medical History Form?


Quick Answer

To create a medical history form, begin by gathering your records, such as a list of all medicines you take, your most recent doctor's visits and any recent illnesses or hospitalizations, says AARP. At minimum, the medical history form should include this information, as well as a your date of birth, blood type, allergies to foods and medicines, information about chronic illnesses, and a record of recent health screenings and diagnostic tests.

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Full Answer

Next, choose the medium for creating the medical history form, advises AARP. Almost any format is acceptable as long as it is accessible in an emergency, portable and secure. A spiral notebook or binder, a spreadsheet, or a simple chart stored on a computer or a removable drive all work well.

Include as much information as possible in the medical history so that any doctor treating you has a thorough picture of your overall health, states AARP. For example, provide a summary of your lifestyle habits, such as whether you smoke, exercise regularly or have recently lost or gained weight. Also include the names of your current medical providers and their phone numbers, the name and phone number of an emergency contact and the name of your health insurance provider and the policy number. If you have an advanced directive or any organ-donation authorization forms, it is a good idea to list them and where they are located as well.

If you need assistance organizing your medical information, a helpful, downloadable resource, Organize My Documents, is available on the AARP website, the organization explains. Additionally, a family-health history record, My Family Health Portrait, is available online from the U.S. Department of Health and Human Services.

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