Medical History Questionnaire
About this template
A medical history questionnaire on letter paper with patient instructions and tables for conditions with dates of onset, family history by relationship, and prior procedures.
Tags
What is in this template
Read from the source files of this template.
- Document class
article[11pt, letterpaper]- Compiles with
- pdfLaTeX
- Pages in the compiled PDF
- 5
- Bibliography
- None
- Files
- 2 files: 1 .tex, 1 image
- Packages
inputencfontenchelvetgeometryxcolortikztcolorboxamsmathamssymbbooktabscolortblarraymultirowtabularxfontawesome5enumitemfancyhdreso-pichyperref
\documentclass[11pt,letterpaper]{article}
\usepackage[utf8]{inputenc}
\usepackage[T1]{fontenc}
\usepackage{helvet}
\renewcommand{\familydefault}{\sfdefault}
\usepackage[margin=0.7in,top=0.55in,bottom=0.55in,headheight=14pt]{geometry}
\usepackage[table]{xcolor}
\usepackage{tikz}
\usepackage{tcolorbox}
\tcbuselibrary{skins}
\usepackage{amsmath,amssymb}
\usepackage{booktabs}
\usepackage{colortbl}
\usepackage{array}
\usepackage{multirow}
\usepackage{tabularx}
\usepackage{fontawesome5}
\usepackage{enumitem}
\usepackage{fancyhdr}
\usepackage{eso-pic}
\usepackage{hyperref}
\definecolor{medblue}{RGB}{25,60,120}
\definecolor{medteal}{RGB}{15,120,115}
\definecolor{medgray}{RGB}{242,245,249}
\definecolor{medaccent}{RGB}{195,85,35}
\definecolor{meddark}{RGB}{40,40,50}
\AddToShipoutPictureBG{%
\AtPageCenter{%
\rotatebox{45}{\textcolor{black!7}{\fontsize{88}{88}\selectfont\bfseries SPECIMEN}}%
}%
}
\fancyhf{}
\fancyhead[L]{\footnotesize\color{medblue!70}Meridian Family Medicine \textbar\ Medical History Questionnaire}
\fancyhead[R]{\footnotesize\color{medblue!70}Confidential}
\fancyfoot[C]{\footnotesize\color{medblue!70}\thepage}
\renewcommand{\headrulewidth}{0.3pt}Put this template on your own page
Paste this badge on a thesis guide, a course page or a README. One click opens the template as a new project in the reader's own LetX account.
[](https://letx.app/open?template=medical-history-questionnaire)<a href="https://letx.app/open?template=medical-history-questionnaire"><img src="https://letx.app/badges/open-in-letx.svg" alt="Open in LetX"></a>Frequently asked questions
What does the Medical History Questionnaire template load?
It uses the article class (options: 11pt, letterpaper), builds with pdfLaTeX, and loads 19 packages, including inputenc, fontenc, helvet, geometry, xcolor, tikz, tcolorbox and amsmath.
How long is the Medical History Questionnaire sample?
The compiled sample is 5 pages, from 2 files: 1 .tex, 1 image. Replace the sample text with yours and the layout stays.
Is the Medical History Questionnaire template free to use online?
Yes. "Open as Template" makes it your own LetX project: edit the LaTeX in the browser, invite collaborators to edit with you in real time, and download the compiled PDF. There is nothing to install.
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