Medium

Available on

Apple Android Windows

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.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

Want to learn more about GoCanvas?

Request a Demo

Take a peek inside the Mobile POC Patient History Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

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

  • Ico date

    Date

  • Ico statictext

    PATIENT INFORMATION

  • Ico statictext

    MEDICAL HEALTH HISTORY

  • Ico textbox

    Patient Name

  • Ico textbox

    Date of Birth

  • Ico integer

    Age

  • Ico textbox

    Physician Name (MD)

  • Ico textbox

    How would you state your present health?

  • Ico statictext

    PLEASE ANSWER YES OR NO, WITH EXPLANATION ON ALL YES ANSWERS:

  • Ico dropdown

    Are you currently under the care of a physician?

  • Ico textbox

    If Yes please explain

  • Ico dropdown

    Have you ever been hospitalized or had any serious illness?

  • Ico textbox

    If Yes please explain

  • Ico dropdown

    Have you had excessive bleeding following an extraction or do cuts take longer to heal now than p...

  • Ico textbox

    If Yes please explain

  • Ico dropdown

    Do you use alcohol or any recreational drug that may have an effect on treatment?

  • Ico textbox

    If Yes please explain

  • Ico statictext

    Integument (skin)

  • Ico checkbox

    Eruptions

  • Ico checkbox

    Abnormal growths

  • Ico statictext

    Head

  • Ico checkbox

    Head and neck injury

  • Ico checkbox

    Recurrent headaches

  • Ico checkbox

    Dizziness

  • Ico checkbox

    Syncope (fainting)

  • Ico checkbox

    Epilepsy

  • Ico checkbox

    Convulsive seizures

  • Ico checkbox

    Stroke

  • ...and More!

Related Health Care & Social Services Apps... and they're all free for GoCanvas subscribers!

App Name

Home Health Care Service Agreement

The Home Health Care Service Agreement mobile app lets you easily complete service agreements for home health care on any ...

App Name

MRSA Infection Control and Epidemiolo...

Multidrug-resistant organism transmission and infection are among the most important current issues in healthcare settings...

App Name

MRSA Infection Control and Epidemiolo...

Multidrug-resistant organism transmission and infection are among the most important current issues in healthcare settings...

App Name

Infection Prevention & Control Progra...

The purpose of the Infection Prevention & Control Program: Hospital Quality Systems Infection Prevention & Contro...

App Name

MRSA Infection Control and Epidemiolo...

This MRSA Infection Control and Epidemiology: Infection Control Risk Assessment Mobile App is designed to evaluate the lev...

App Name

Urine Output Log

The Urine Output Log mobile app for health care providers tracks patient bladder functions, habits and patterns. A useful ...

App Name

Autoclave Self-Audit Checklist

Autoclave chambers offer sterilization of objects using high pressure steam. This sterilization process is popular in many...

App Name

Doctor Visit Note

The Doctor Visit Note mobile app helps you be prepared for your next doctor's visit. Keep track of diagnosis, prescribed t...

More Information