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Medical History


This form was created to illustrate a general medical history. It demonstrates a simple form layout of 48 check boxes and provides space for medical explanations.

Figure 1: Medical History Form

Figure 2: Medical History Workflow


This form and associated workflow provide a means for timely response to a patient's basic medical history. It uses 48 check boxes to compile past medical concerns from chicken pox and shingles, to anemia and diabetes. It also provides basic patient information as well as areas for further explanation of past and current problems. The workflow passes the Form information from the Admittance Department to Patient Care down the line to Diagnostics and the Records Department. It can also be implemented on a company level to screen employees.

To view a working example of this form visit the Virtual Sandbox.


File Name Size Last Updated Version Deployment Time
4.44 KB 02/19/2010 Vibe 3.1, 3.2, 3.3 45 minutes
9.53 KB 08/1/2011 Vibe 3.1, 3.2, 3.3 15 minutes

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