What Is a Health History Template?


Quick Answer

A health-history template is a form that summarizes an individual's past and present state of health, states Good Housekeeping. It typically includes a brief medical history, a list of current medications, any current medical conditions, and the names and phone numbers of the person's doctor.

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Full Answer

The template also includes the person's insurance information, allergies, current immunizations and date of birth. Having this information on hand is helpful in a medical emergency when the person is injured or too ill to respond to questions about his health. It is a good idea to have a form on file for each member of the family, Good Housekeeping explains.

A printable personal-health-history template prepared by the American College of Emergency Physicians is available online at ACEP.org. The site also provides a form for children with special health care needs and a consent-to-treat form for parents of minor children.

In addition to a personal health history, a family health portrait is also a helpful tool, the Office of the Surgeon General explains. Information about the health of family members helps people learn about their risk of health conditions that run in families and helps doctors screen for these conditions as well. A comprehensive family health history template prepared by the Office of the Surgeon General in collaboration with the National Human Genome Research Institute is available on the website of the Department of Health and Human Services.

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