Yearly Physical Examination Form

An annual physical examination is important for assessing a person’s health condition. Any underlying medical issues can be diagnosed and treated on time through this examination. The findings are written down in a form.

Form format…

A well-designed yearly physical examination form helps doctors organize the information in a better way. Here are the important contents of this form.

  • Basic information about the patient is presented at the top of the form. This part is mostly filled by the patient himself. It includes his name, age, gender, contact number, and address. Additionally, the date of the examination, emergency contact number, and date of the previous exam may also be included.
  • The next section should be filled with information about the patient’s medical history. It typically includes allergies, diabetes, blood pressure, or any other information worth highlighting. This section is also filled by the patient for his physician.
  • Further information provided by the patient is a list of the medications that he takes on a regular basis. These may include medicines for diabetes, blood pressure, or asthma.
  • In the case of children, a record of vaccination should be provided. This includes the names of vaccines and the dates on which each vaccine was administered.
  • In the case of adults, a vaccination record for diseases like hepatitis, typhoid, and COVID is provided.
  • The next section contains a record of previously done surgical procedures if any.
  • The physician now needs to fill out the next sections. These include findings of the general physical exam. The doctor uses checkboxes and provides his own comments if necessary.
  • In the end, the last section consists of information about the physician. His name, contact number, and signatures are provided. Additionally, he may also provide a date for the next physical examination.

Pre-designed templates…

All of the above information makes a physical examination form complete. More information can be added according to the requirements of hospitals and clinics. It is not difficult to design this form. Pre-designed templates can be customized and printed out for use.

If you want to create…

Here are instructions to create a yearly physical exam form.

  • Browse through the templates available for a physical examination form.
  • Make your selection based on how much information you need in your form. Choose a template that is appropriate according to your preferences.
  • Use the provided editing tools to customize the form. You can add or delete various sections. You may also change the font style, size, and color. Also, it is important to add the name of your hospital or clinic at the top of the form.
  • Download and print the customized form.

A physical examination form is a formal medical document. There are no fancy graphic elements like pictures or borders. It is a simple presentation of important medical information. Therefore, the designing of this form is a simple process. Using online templates makes it simpler. All you have to do is focus on the questions and sections to be added. Adjust the font and your form for the yearly physical examination will be ready.

End-of-year medical exam…

A yearly physical exam is an end-of-the-year medical exam that helps patients and doctors in knowing the overall health of the patient. Many people take this exam to satisfy themselves that they are as healthy as they feel, whereas others take it in more cautionary terms to document any disease, ailment, or risk factor that may affect them.

A tool used by doctors…

The examination form is used by doctors to document the vitals and notes after the yearly exam. This form usually contains prior medical history such as previous tests, ailments that the patient treated, and the medication being used by the patient. Current medical conditions are also mentioned along with any medication that the patient is using.

Parts of the form…

A separate section regarding the patient’s lifestyle is also mentioned in the form which asks the patient whether or not he/she smokes, takes drugs, consumes alcohol, diet they take and whether or not do they exercise.

A vaccination section is also available that documents any recent or prior vaccines the patient has got. Updates in the family health history are also recorded in this yearly physical exam form. After every piece of information has been mentioned, the doctor can either run some tests or can advise the patient accordingly.

This form needs to cover every aspect of a patient’s medical history and present. The age, gender, and last date of examination should also be mentioned since these small bits of information can aid in better diagnostics.


Yearly physical examination form

FileWord (.doc) 2007+ and iPad 
Size 68 KB

Form Templates…