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DHA Endoscopy LLC 91 Mont vale Ave. Suite # 103 Stone ham, MA 02180 7818352111 DHAENDOSCOPY.COM Patient Name Date of Birth READMISSION QUESTIONNAIRE Primary Care Physician Procedure Endoscopic Reason
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How to Fill Out Pre-Admission Questionnaire - DHA:

01
Start by carefully reading the instructions provided with the questionnaire.
02
Complete all personal information sections accurately, including your full name, date of birth, address, and contact details.
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Provide details about your medical history, including any pre-existing conditions, surgeries, or allergies. Make sure to include the dates and names of any medications you are currently taking.
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Answer the questions related to your lifestyle, such as smoking or alcohol consumption, as honestly as possible.
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Fill out the sections regarding your current health status, including any symptoms or recent illnesses.
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Provide information about your family medical history, especially if it includes any hereditary conditions.
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If applicable, include details about your previous hospitalizations or medical treatments.
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Double-check all the sections to ensure that you have filled out everything accurately and completely.
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If you come across any questions that you are unsure about, it's best to consult with your healthcare provider or a medical professional for clarification.
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Finally, carefully review all your answers before submitting the completed pre-admission questionnaire.

Who needs Pre-Admission Questionnaire - DHA:

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Individuals who are scheduled for an upcoming medical procedure or surgery in a hospital or healthcare facility.
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Patients who are seeking admission to a hospital for various healthcare services such as diagnostic tests, treatments, or consultations.
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People who have been referred by their healthcare provider or specialists for a specific medical evaluation or intervention.
Remember, the pre-admission questionnaire is designed to gather important information about your health, medical history, and lifestyle. This information helps healthcare professionals provide appropriate care and ensure your safety during your hospital stay or medical procedure.
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The pre-admission questionnaireb - dha is a form that must be filled out by individuals seeking admission to a hospital or healthcare facility in Dubai Health Authority (DHA) jurisdiction.
Any individual seeking admission to a hospital or healthcare facility in Dubai Health Authority (DHA) jurisdiction is required to file the pre-admission questionnaireb - dha.
The pre-admission questionnaireb - dha can be filled out either online or in person at the hospital or healthcare facility. The form must be completed accurately and truthfully.
The purpose of the pre-admission questionnaireb - dha is to gather necessary information about the patient's health history, current condition, and any special requirements or accommodations needed during their stay at the facility.
The pre-admission questionnaireb - dha typically asks for information such as medical history, current medications, allergies, emergency contacts, and any specific instructions from the patient's healthcare provider.
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