Yearly Physical Examination Form

A physical examination once a year is recommended for every healthy and ill person because any person at any age can catch a disease and get far away from wellness. The yearly checkup helps a person and his healthcare professional monitor his health. If there is any medical condition that has not occurred yet but is approaching, the doctor can warn the patient, and he can completely dismiss it by taking preventative care.

What is an annual medical checkup form?

It is a document that includes several empty fields to be filled in by the patient to access key information about the well-being of the person. These details are then useful for the doctor and other medical staff who want to determine the overall health and wellness of the person. Getting a medical evaluation is extremely important for patients, as they can get their illness detected at a very early stage, and due to this, it becomes easy for the doctor as well as the patient to manage the disease and prevent it from spreading.

Who uses it?

As the name suggests, the medical checkup form created for a yearly checkup is used by doctors, caregivers, and other medical staff who have been assigned the task of collecting necessary data from the patient before further checkups are done. This form becomes the basis for the comprehensive hospital data that is useful in a number of ways.

What are the reasons to use the annual physical checkup form?

The medical staff extensively uses this form whenever a patient visits the hospital for an annual checkup. This form only takes those readings from the patient that are related to the yearly checkup. Here are the top reasons behind using this form:

It is helpful in data collection

Performing checkups and getting to know about the overall health and well-being of the person is not possible unless some necessary data is collected from the patient. The information taken from the patient is sent to the doctor who then performs necessary tests and goes for some special checkups depending on the information collected.

It is time-saving

Having a look at the form gives plenty of information to the doctor and he does not have to ask several things from the patient time and again. This way, the time of the doctor is saved and he can entertain other patients easily.

It helps write prescriptions

Sometimes, considering the information obtained from the form, doctors have to prescribe some medication or change the previously prescribed medicines. Based on the symptoms the patient has revealed and some other information, the prescription can be changed, and the information taken from the form is usually helpful in this way.

What information is collected?

As has been said earlier, the data collected with the help of the annual checkup assessment form is highly useful. Therefore, a hospital needs to be sure of the type of information it collects. Here are the key elements of the form:

Brief information about the patient

The patient is asked to provide his basic information, such as name, age, gender, occupation, place of residence, etc.

Medical diagnosis

There is a section in which a patient is required to mention the medical diagnosis he has had in the past. This will let the healthcare provider know about the ailments the patient is already suffering from.


There is a list of symptoms that a person may experience. People who fill out the form have to choose any of those symptoms that they have experienced over the last year. This will help the doctor with efficient diagnosis and treatment.

Vaccination details

If the patient has had shots, he is required to mention for which disease and how long ago. Sometimes, people face some medical issues because of the immunizations they go through. Therefore, the form asks the visitors to fill out this part.

Family history

For a better diagnosis and treatment, doctors often ask the patient to provide the details regarding family history. This helps them do the risk assessment and keep the patient alert and careful about his lifestyle and diet. For instance, obese people are at risk of diabetes if they have it in their family. They can easily know about it if they share their family history.

YEARLY PHYSICAL Examination form

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