Health History
A standardized, universal health history form that can be completed by the patient before their appointment, and easily updated at subsequent appointments.
Description#
This comprehensive template includes all medical and dental history, highlighting health facts and automatically including them in the patient chart. The form also incorporates a smoking cessation component.
Sample#
View a sample PDF of this template.
Actions#
Request this template for your ICE Health Systems environment.
Provide feedback about this template.
Details#
| Version | Origin / Contributors |  |
|---|---|---|
| 1 | University of Michigan | Attribution 4.0 International |