Physical Exam Form

Physical Exam Form Template

The physical exam form is perfect to use for any age group. The form is customizable and easy-to-use. In order to get the form today for free, you will just need to download it from this page.

What Information is on the Physical Exam Form?

  • The first block will ask for the patient’s name, date of birth, age, and the date and time the physical is being done.
  • The second block will need any information regarding allergies, the patient’s height, weight, blood pressure, pulse, LMP, problems addressed, medications, and RXs written.
  • The third block will go over any risk factors that were found. It will list diet, exercise, safety, smoking, alcohol and other drugs, STDs or contraception, advanced directive, or any other issues. Also, the third block will go over disease prevention and recommendations.
  • Next, the chart will ask for a health maintenance date that will need to be scheduled with the patient.
  • The fifth block will ask for records of immunizations taken, lab work, or any other types of medical information needed.
  • The last block on the first page will ask for follow-up information, next physical date, additional history discussed, updated family history, and updated surgeries.
  • The second page 1st block will ask for a repeat of the patient’s name, date of birth, age, and the date and time of the physical.
  • The 2nd block will go over ROS.
  • The last block will go over every aspect of the physical exam.

Tips on Using the Physical Exam Form

  • Each office is different, there may be some information on the physical exam form that you do not need. You can simply edit the form to fit your office needs for the types of physical exams done.
  • Questions on the physical exam form can be updated.
  • Additional information can be added to the form.

Be sure to download the physical exam form today from this page. It only takes a matter of seconds. Then, you will be able to customize the form to fit your business’s needs.

Download: Physical Exam Form

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