Health History Forms

The Health History Forms page allows you to fill out and submit health history forms (e.g., family medical history, allergies etc.) through MyHealthRecord.com.

The Health History Forms page is not available to all patients.

How to Get Here

Go to My Health and then select Health History Forms from the menu.

How to Complete Forms

1. Select the form you want to complete.
2. A new window opens with the form you selected.
3. Select the options that apply to you, or None if the condition does not, or Other.
4. If you selected Other, select the details button.

5. In the pop-up, enter another item into the field and then select Add to List. To remove an item, select Remove. Click Save when finished.

6. When done with each page, select Next to continue to the next page (if available), or Finish Later if you need to stop for any reason.

All questions marked by a red asterisk (*) are required. If they are not answered, you will not be able to complete the form.

7. On the last page of the form, select a provider from the drop-down list. If your provider is not on the list, select "Physician not in this list."
8. Select Yes or No to the question "Are you the user on account?".
9. If you are ready to send the form to your provider, select Send Form.

All completed and submitted forms will be marked as Submitted in your Health History Forms menu.