QuestionHealth History Worksheet This worksheet is used to assist the student in gathering and organ
QuestionHealth History Worksheet This worksheet is used to assist the student in gathering and organizing information when conducting a health history. Family Member DescriptionPaternal grandfatherFirst and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Paternal grandmotherFirst and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: FatherFirst and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Father’s siblings- Summary of any significant health issues Maternal grandfatherFirst and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Maternal grandmotherFirst and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: MotherFirst and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Mother’s siblings- Summary of any significant health issues Adult Participant First and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Adult participant’s siblingsSummary of any significant health issues Adult participant’s spouse/significant otherFirst and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Adult participant’s children- Up to 4 children Child #1 first and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Child #2 first and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Child #3 first and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Child #4 first and last initials: Birthdate: Death date: Occupation: Education: Primary language: Health summary: Health ScienceScienceNursingNR 302Share Question
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