medical reports forms

Basically, a medical report form is a document which will contain the summary of the assessments, observations, and the clinical history of a patient or an individual who underwent a medical treatment with the physician who provided the medical report. In addition, a medical report form in a word format is a type of medical report form in “.DOC” format or in a word document format which can be accessed using a word-processing software application known as Microsoft Word. However, this format can also be opened using other word-processing software applications including the OpenOffice Writer, Corel WordPerfect, and LibreOffice Writer.

What is Medical Report Form?

A medical report form is a document used by healthcare providers to record a patient’s medical history, current health status, diagnoses, treatments, and progress. It typically includes sections for personal information, medical history, symptoms, examination findings, test results, diagnoses, treatment plans, and recommendations. This form serves as a comprehensive record of a patient’s medical journey and is essential for ensuring continuity and quality of care. It’s also used for legal, insurance, and administrative purposes. You also browse our Medical Records Release Forms.

What is the best Sample Medical Report Form?

This sample medical report form provides a template for healthcare providers to document patient information and medical findings.

Medical Report Form

Patient Information

  • Name: ___________________________
  • Date of Birth: ____________________
  • Gender: _________________________
  • Address: _________________________
  • Phone Number: ___________________
  • Emergency Contact: _______________

Medical History

  • Past Medical History:
    • [List any previous illnesses, surgeries, hospitalizations]
  • Current Medications:
    • [List all medications including dosage]
  • Allergies:
    • [List any known allergies]

Present Illness/Injury

  • Date of Onset: ___________________
  • Symptoms Description:
    • [Describe the symptoms and their duration]

Physical Examination

  • Vital Signs:
    • [Blood pressure, heart rate, temperature, etc.]
  • General Appearance:
    • [Observations about patient’s general state]
  • System Review:
    • [Findings from examination of different body systems]

Diagnostic Tests

  • Test Name:
    • [Results and interpretation of each test conducted]


  • Primary Diagnosis:
    • [Diagnosis based on examination and test results]
  • Differential Diagnosis:
    • [Other possible diagnoses considered]

Treatment Plan

  • Medications Prescribed:
    • [List with dosages and instructions]
  • Therapies/Procedures:
    • [Details of any recommended therapies or procedures]
  • Follow-up Instructions:
    • [Guidelines for patient follow-up care]

Doctor’s Information

  • Physician’s Name: ___________________
  • Signature: _________________________
  • Date: ______________________________

Instructions for Use:

  • Fill out each section with accurate and detailed information.
  • Ensure confidentiality and secure storage of the form.
  • Use the form for ongoing patient care, referrals, and insurance purposes.

Note: This medical form is a template and can be modified to suit specific medical practice needs. Regular updates and accuracy are crucial for effective patient care management.

7+ Medical Report Forms in MS Word | PDF

Medical Report Form Sample

File Format
  • DOC

Size: 19 KB


Medical Device Incident Report Form

File Format
  • DOC

Size: 27 KB


Medical Physical History Report Form

File Format
  • DOC

Size: 17 KB


Medical Physical History Report Form – This is the type of medical report form which will be for disclosing the medical and physical history of an individual. In a medical physical history report form, the user will be required to disclose all of his medical and health conditions including the allergies that he has and the infectious diseases that he had in the past.

Editable Medical Report Form

File Format
  • PDF

Size: 141 KB


Medical Report Release Authorization Form

File Format
  • DOC

Size: 5 KB


Medical Report Release Authorization Form – After a medical report form is filled out by the patient and the physician, a medical report release authorization form must be provided to the patient. Although this document should not be given as a mandatory form, it is necessary or essential to be handed to the patient since it is for obtaining the patient’s permission and consent for the medical institution to use his information, as well as disclose his information to the organization who requested the report.

Medical Report Request Format Form

File Format
  • DOC

Size: 5 KB


Medical Report Request Form – This is the form to be used by an employer of a physician’s patient who has submitted a job application to the employee and has been selected as one of the prospective job candidates for the position that he is applying for. Specifically, a medical report request form is a formal letter addressed to the physician to inform him that the company, who is the sender of the form, wants to obtain a copy of a patient’s or a job applicant’s medical report as part of the job application requirements.

Customer Medical Report Form

File Format
  • PDF

Size: 883 KB


Medical Condition Report Downloadable Form

File Format
  • PDF

Size: 424 KB


Though there are different types of medical report forms, when using the form, a physician should know and keep in mind the purpose and the goal of the document which is to gather the information of a patient. Moreover, if the form will be sent to another party, the owner of the information or the patient whom the physician administered tests to, should be informed about the intents of the other party, and must give his approval for the usage and the disclosure of his information. You should also take a look at our Patient Report Forms.

Why Use a Medical Report Form in Word Format?

There are a lot of benefits in using a medical report form in word format, and one of the known benefits is that it is the most popular format that the population uses compared to other formats. This is due to the history of word-processing software applications which came first before other applications associated with other formats including “.PDF”, and “.XLS”. In lieu of this, a medical report form in word format will be easy to navigate and use.

Another benefit is that a medical report form in word format is lightweight which means that it will not take up much storage space from the device where it will be downloaded and be saved. Moreover, due to its lightweight feature, it can easily be uploaded as well if the intent of the medical institution or any organization is to use the document online on their website. You may also see Medical Examination Forms.

Lastly, a medical report form in word format is the basis or can be the building blocks of other formats which then allows the organization to convert the medical report into other formats depending on what they will be preferring to use.

How to Create a Medical Report Form in Word

In creating a medical report form in word, one must first open a word-processing software application or program. Then, the measurements and styles to be used in the form must be defined such as the line-spacing, text or font sizes, and the margins. After setting up the document or sheet to be used, the steps below must be followed:

Step 1: Add the brand banner. This refers to the banner which contains the name of the medical institution and its logo. Additionally, the banner can also be made in simply in the header of the document sheet which is at the topmost margin of the form. Other than the name and logo of the medical institution, their contact information and their main office address can be incorporated into the banner as well.

Step 2: State the instructions and guidelines to be followed. This is where the user of the form will be able to know when the form must be used and what other requirements must be submitted or be enclosed along with the submission of the medical report form.

Step 3: Place the title of the form. The title of the form can be generalized or specified depending on the preferences of the medical institution. For instance, the title can be “Medical Accident Report Form” if the form is to be made for patients or victims of accidents and injuries, while a Medical Physical Report Form can be used if the document is intended to be used for athletes or for physical therapy patients. Regardless of the variation, the font to be used should highlight and emphasize the title of the form.

Step 4: Add a section of the basic information of the patient. Also known as the patient information section, this area of the form must be able to gather the basic data of the patient such as the patient’s name, address, phone number, gender, marital status, and blood type.

Step 5: Enlist the medical conditions to be examined and assessed by the physician. There can be a lot of different medical exams to be taken by patients depending on the need of the organization who required the medical report and depending on the patient’s previous medical report or assessment. This is why it is important to list the types of medical conditions to be checked by the physician along with the specific medical tests to be administered to the patient.

Step 6: Create a section for the decision of the physician. This section can indicate a question regarding the patient’s eligibility to join activities. In this section, the physician should be able to affix his signature, the date when he signed the form, and explain his decisions.

Step 7: Save the form. When saving the form, the title of the document should be the file name as well. This is to ensure that there will be proper identification of files and that the form will be located immediately when searching through the device where it is saved. Our Medical Clearance Form is also worth a look at.

Types of Medical Report Forms

Type of Medical ReportDescription
History and Physical Report (H&P)A comprehensive record detailing a patient’s medical history and physical examination findings at the time of admission.
Operative ReportDocuments the details of a surgery, including the surgical procedure performed, findings, and post-operative care.
Discharge SummarySummarizes a patient’s hospital stay, including the reason for admission, treatment provided, and condition at discharge.
Pathology ReportProvides the analysis of tissue samples, often used to diagnose diseases like cancer.
Radiology ReportInterprets results from imaging studies such as X-rays, CT scans, and MRIs.
Progress NotesRegular updates written by healthcare providers on the patient’s condition, treatment, and progress during hospitalization.
Laboratory ReportDetails the results of laboratory tests, including blood tests, urine analysis, and other diagnostic tests.
Consultation ReportWritten by a specialist upon request of the primary care provider, offering expert opinions on a patient’s condition.
Emergency Room ReportDocuments the patient’s condition, treatment, and care provided during an emergency room visit.
Prescription RecordsLists all medications prescribed to a patient, including dosage and instructions for use.

These reports play a crucial role in patient care, providing detailed and specific information that guides diagnosis, treatment, and follow-up.

How do you request for a Medical Report?

To request a medical report, follow these steps:

  1. Identify the Healthcare Provider: Determine which doctor, hospital, or clinic holds the medical records you need.
  2. Contact the Healthcare Provider: Reach out to the provider’s office or medical records department. This can be done via phone, email, or in person.
  3. Request Forms: Ask for any specific forms required to request the medical report. Many providers have standard forms for this purpose.
  4. Complete the Request Form: Fill out the form with all necessary details, including patient name, date of birth, specific information or dates of service needed, and the reason for the request.
  5. Provide Identification: You may need to provide proof of identity or a signed authorization, especially if you are requesting records on behalf of someone else.
  6. Specify Delivery Method: Indicate how you would like to receive the medical report (e.g., email, postal mail, in-person pickup).
  7. Submit the Request: Send the completed form and any additional documentation to the healthcare provider.
  8. Follow Up: If you don’t receive the report within a reasonable time frame, follow up with the provider’s office.
  9. Review the Report: Once received, review the medical report for completeness and accuracy.

Remember, healthcare providers are required to maintain confidentiality and privacy of patient records, so they will have procedures in place to ensure that medical reports are released appropriately and securely. You may also see Blank Medical Forms.

Difference between Medical Report and Medical Certificate?

AspectMedical ReportMedical Certificate
DefinitionA detailed document that provides comprehensive information about a patient’s medical history, diagnosis, treatment, and current health status.A formal statement from a doctor or healthcare provider certifying a patient’s health condition, often for specific purposes like sick leave or fitness.
ContentIncludes patient history, symptoms, diagnostic test results, treatments, progress notes, and doctor’s observations.Generally contains limited information, such as the nature of the illness, the date of examination, and the doctor’s recommendation regarding the patient’s ability to work or participate in activities.
PurposeUsed for detailed medical assessments form, insurance claims, legal cases, or as a medical record for ongoing treatment.Used to certify a patient’s health status for employers, schools, or legal requirements, such as sick leave or physical fitness.
Length and DetailTypically lengthy and detailed, providing a comprehensive view of the patient’s medical condition.Usually brief and concise, focusing only on the specific aspect of the patient’s health relevant to the certificate’s purpose.
Issued ByWritten and signed by the healthcare provider who conducted the examination or is overseeing the patient’s care.Issued and signed by a qualified healthcare professional, often after a specific examination for the certificate’s purpose.
Legal WeightCan be used as evidence in legal proceedings or for complex medical evaluations.Holds legal validity for its intended purpose but is not as comprehensive as a medical report for detailed evaluations.

Both medical reports and certificates are important documents in healthcare, serving different purposes based on the level of detail and specific requirements of the situation.

What is Included in a Medical Report?

A medical report includes patient history, symptoms, diagnosis, treatment details, test results, doctor’s observations, and progress notes, providing a comprehensive health overview. In addition, you should review our Medical Waiver Forms.

How to Give a Medical Report

To give a medical report, compile detailed patient information, diagnosis, treatment, and progress, ensuring accuracy and clarity, and present it to the intended recipient following confidentiality protocols.

What is the Purpose of a Medical Report?

The purpose of a medical report is to document a patient’s medical history and current condition, aiding in ongoing treatment, legal cases, insurance claims, and healthcare analysis. You may also be interested in our printable form.

How Effective is Medical Report?

A medical report is highly effective as it provides a detailed and accurate record of a patient’s medical history and current condition, crucial for informed healthcare decisions and treatments.

What is Discharge Summary Report?

A discharge summary report is a document provided to a patient upon hospital discharge, summarizing the reason for admission, treatment received, condition at discharge, and follow-up care instructions.

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