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MAN: Patient Name: NEW PATIENT QUESTIONNAIRE INTERNAL MEDICINE (Patient Label) What brings you in today? Please list all of your medical conditions. 1. 5. 2. 6. 3. 7. 4. 8. What surgical or medical
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Individuals visiting a healthcare facility or doctor's office may need to fill out a "what brings you in" form to provide information about their symptoms or medical condition.
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What brings you in refers to the reason or purpose for your visit or attendance.
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