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Mobile POC Patient History Mobile App

The Patient History mobile app allows health care providers and clinicians to collect a detailed medical history from its patients. The form features sections that allow users to enter the basic patient data, answer medical questions, choose their medical issues from an extensive list, report their allergies and medications, and sign the medical history. A patient can also include family history, past physical examinations, and any other health history.

All medical records are securely stored in the GoCanvas Cloud. They can be emailed or printed as a PDF if you need to send them to a primary care physician or keep for your records. This app can be downloaded to an iPhone, iPad, or Android device.

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Take a peek inside the Mobile POC Patient History Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

Date
PATIENT INFORMATION
MEDICAL HEALTH HISTORY
Patient Name
Date of Birth
Age
Physician Name (MD)
How would you state your present health?
PLEASE ANSWER YES OR NO, WITH EXPLANATION ON ALL YES ANSWERS:
Are you currently under the care of a physician?
If Yes please explain
Have you ever been hospitalized or had any serious illness?
If Yes please explain
Have you had excessive bleeding following an extraction or do cuts take longer to heal now than p...
If Yes please explain
Do you use alcohol or any recreational drug that may have an effect on treatment?
If Yes please explain
Integument (skin)
Eruptions
Abnormal growths
Head
Head and neck injury
Recurrent headaches
Dizziness
Syncope (fainting)
Epilepsy
Convulsive seizures
Stroke
...and More!