Questions to answer within the assignment & along with rubric: Demographics: •

Questions to answer within the assignment & along with rubric:
Demographics:

Questions to answer within the assignment & along with rubric:
Demographics:
• provide your age, gender
• What is your occupation, and are there any specific environmental factors related to your work or home life that might affect your health?
2. Perception of Health:
• How do you perceive your overall health at the moment? What are your health goal’s?
3. Past Medical History:
• Have you had any significant medical conditions or surgeries in the past?
• Any known allergies?
• Immunization up to date?
• Tobacco use? 
• Illicit drug use 
• Are you currently taking any medications or supplements?
4. Family Medical History:
• Do you have immediate family history of any medical conditions like heart disease, diabetes, or cancer? (Include specifically which immediate family member) and what age did it occur?
5. Review of Systems:
• Skin and Nails (History skin cancer, Itching, Bruising, Rashes, Change in hair or nails)
• Head and Neck (Headaches, Head injury)
• Eyes (Glasses or contacts, Change in vision, Eye pain, Double vision, Flashing lights, Glaucoma/cataracts)
6. Developmental Considerations:
• Are there any specific milestones or changes related to your age or life stage that you think are important for your healthcare provider to know about?
• Are you experiencing any age-related concerns, such as menopause or issues related to childhood development?
7. Cultural Considerations:
• Are there any cultural or religious practices that might impact your healthcare decisions or preferences?
• Do you have any specific cultural beliefs or traditions related to health and wellness?

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