Are you looking for a professional and easy-to-use Physical Exam Form?
Many websites charge for similar templates, often available only in PDF format, making them difficult to edit.
We are offering a 100% free, editable Google Docs template that you can customize, fill out, and print as needed.
Why Choose Our Google Docs Template?
✅ 100% Free & Editable – Unlike paid PDF forms, you can modify this form as per your needs.
✅ Professional & Well-Structured – Designed for clinics, hospitals, and private practices.
✅ Instant Access & Easy Customization – Simply make a copy and start using it right away.
✅ Print & Digital-Friendly – Works for both physical documentation and electronic records.
What’s Inside the Template?
This user-friendly Physical Exam Form includes essential fields for comprehensive medical evaluation:
Patient Information
- Name
- Date
- Chart Number
- Chief Complaint
- History of Present Illness (HPI)
- Occupation
- Marital Status (M / S / W / D)
Immunization Status
- Up to Date
- Needed
Vital Signs & Physical Exam
- Weight (WT)
- Height (HT)
- Pulse
- Blood Pressure (BP)
- Temperature (TEMP)
Medical History
- Past Medical History (PMH)
- Hospitalizations
- Previous Illnesses
- Childhood Illnesses
Current Medications & Allergies
- Current Medications
- Allergies
Family Medical History
- Mother
- Father
- Maternal Grandparents
- Paternal Grandparents
- Other Relatives
Social & Lifestyle History
- Smoking Status
- Alcohol Use
- Obstetrical & Gynecological History (GRAVA, PARA, LMP, REGULAR PERIOD, etc.)
- Mammography & Self-Breast Exam
- Pap Smear
Review of Systems
The form includes a detailed section for reviewing different body systems:
- HEENT (Head, Eyes, Ears, Nose, Throat)
- Neurological
- Respiratory
- Endocrine
- Cardiovascular (C-V)
- Psychiatric
- Gastrointestinal (G.I.)
- Skin
- Genitourinary/Gynecological (GU/GYN)
- Musculoskeletal
Physical Examination Findings
- General Appearance
- HEENT
- Lungs
- Heart
- Abdomen
- GU/GYN
- Extremities
- Neurological
- Skin
- Laboratory Tests
Diagnosis & Follow-Up
- Impression
- Prescriptions (RX)
- Follow-Up Instructions
Physical Exam Form Template
Using this Google Docs Physical Exam Form Template is simple:
- Click the “Get this template” button to open the form in Google Docs.
- Click “Use Template” to make a copy.
- Edit as needed – Fill in the patient’s details, modify sections, and customize the form.
- Print or share digitally – Easily print the form or save it for electronic documentation.