{domain:"www.migrantclinician.org",server:"169.47.211.87"} Skip to main content

x

Migrant Clinicians Network
About
Our Story
Our Staff
Offices
Board of Directors
Institutional Review Board
Career Opportunities
Awards and Accolades
MCN MAKES A DIFFERENCE IN 2020

Our 2023 Impact Report is Available!
Our Work
Building Clinician Capacity

Education and Training
Technical Assistance
Witness to Witness: Clinician Support
Farmworker Health Network

Virtual Case Management

Health Network
#HealthNetworkHelpsPeople
Healthy Babies, Children, and Mothers
Specialty Care Access Network

Environmental Justice and Worker Health

Avian Flu
Heat
Pesticides
Wildfires
Community Engagement

Ventanilla de Salud
Photovoice Projects
Intimate Partner Violence

Climate Crisis

Climate Justice

Health Justice

Agenda & Review
Kugel & Zuroweste Health Justice Award
The Jillian Hopewell Fellowship
Position Statements
Words Matter

Ethics in Research
Engage
Find Learning Opportunities
Request Technical Assistance
Enroll a patient in Health Network
Submit a research protocol
Find Clinician Resources
Receive MCN Updates
Award Nominations
Donate
News
Blog
MCN in the News
Network News
Peer Reviewed Publications
Press Releases and Announcements
Podcasts
Streamline
Explore
Migration

Understanding Migration
Migrant Health Overview
Migrant / Seasonal Farmworkers Profile

Environmental Justice and Worker Health

Dairy Worker Safety
Environmental Education
ESL Health and Safety
Heat
Pesticides
Wildfires
Workers' Compensation
Issues in Migrant Health

Avian Flu
Behavioral Health
Cancer
Children's Health
Climate
COVID-19
Diabetes
Hepatitis
HIV/AIDs
Hypertension
Immunizations
Intimate Partner Violence
Misinformation
Mpox
Oral Health
Tuberculosis
Women's Health
…

Select your language

change language
Search

Search
Account
User account menu

Log in
Donate

User account menu

Log in

Search

Select your language

change language

P.O. Box 164285
Austin, TX 78716
(512) 327-2017
(512) 327-0719
mcn@migrantclinician.org

Adult Medical History Form2-SPANISH

twitter
facebook
linkedin
email

A Spanish translation of the Adult Medical History Form.

Download Resource

HistoriaMedica.doc (62 KB)

Categories

Health History Forms

Medical Records

Open modal

Related Resources

more101+47

Depo-Provera Interval History Form

A sample Depo-Provera interval history form in English and Spanish.
Adult Health History Questionnaire

Adult health history qustionnaire with a number of social and behavior related questions.
Social History Form-SPANISH

A Spanish translation of the 1-page sample social history form.
Brief Sex History Questionnaire

This questionnaire may be used as part of the review of systemswith patients. The clinician might begin, "I need to ask a fewshort questions about…
Adult Medical History Form1-SPANISH

A Spanish version of the Adult Medical History Form.

facebook
twitter
instagram
youtube
linkedin

Migrant Clinicians Network —

Migrant Clinicians Network does not discriminate on the basis of race, color, national origin, gender identity, sexual orientation, age or disability in our program/activities.

Created, Maintained, and Optimized by

PerfectCube, LLC