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University of South Florida, Tampa USF Gynecology and Reconstructive Surgery (813) 4471618 A. Patient History 1. Appointment Date: 3. Patient name: Last / / 2. ID: 4. Birth Date: First / / 5. Date
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Provide your personal information such as your name, date of birth, and contact details in the designated fields.
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Answer the medical history-related questions honestly and accurately. This may include previous surgeries, medications, allergies, and any existing medical conditions.
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Who needs usf-urogyn-followuppatientquestions-10-10-07doc - health usf:

01
Patients visiting the USF Urogynecology Department for a follow-up appointment.
02
Individuals who have previously filled out this form and are returning for additional medical evaluation or treatment.
03
Patients who have undergone urogynecological procedures or treatments and are required to provide updated information.
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This document is a follow-up questionnaire related to urogynecology health at USF.
Patients who have undergone urogynecology procedures at USF are required to fill out this follow-up questionnaire.
Patients can fill out the questionnaire by providing accurate and honest responses to the questions related to their urogynecology health.
The purpose of this document is to gather feedback and information from patients who have received urogynecology care at USF for follow-up and evaluation purposes.
The questionnaire may ask about symptoms, recovery progress, satisfaction with care received, and any ongoing concerns related to urogynecology health.
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