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Leading adult education through support for and the effective application of technology.

Adult and Family Education: Reading a Medical History Form

Example Web Site and/or Technical Equipment Required


Website Example:

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Computer(s), Internet access, projector

Activity Description

In this activity, students read a completed medical history form and answer seven multiple-choice questions about the information provided.


  1. Review the activity provided at the Example Web Site above.
  2. Teach the vocabulary contained in the medical history form.
  3. Put the link to this activity on the desktops of each student computer, or if you have your own Web site, link it there.


  1. Review vocabulary related to a medical history form.
  2. Direct students to the Example Web Site.
  3. Have students read the medical history form and answer the comprehension questions.
  4. Have the students show you their scores when they are finished with the activity.
  5. Display the medical history form on the digital projector and review the answers with the class.

Teacher Tips

  • Students should have basic computer and Web page navigation skills before conducting this activity.

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  • Beginning High
  • Intermediate Low


Basic Communication

  • (3.6) Understand basic health and medical information
  • (3.2) Understand forms related to health care
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OTAN activities are funded by contract CN200091-A2 from the Adult Education Office, in the Career & College Transition Division, California Department of Education, with funds provided through Federal P.L., 105-220, Section 223. However, OTAN content does not necessarily reflect the position of that department or the U.S. Department of Education.