It is typically attached to the. In order to complete your history form, you must gather all your medical records such as your medications, recent illnesses, recent visits to your doctor and hospitalizations. This template is ideal for healthcare providers, clinics, and hospitals that need a. To fill out this form, begin by entering the patient's basic information, such as name and date of birth. Help your patients take charge of their health and maintain a personal health record using our pdf personal health record template with a medication table, vaccination.