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WASHINGTON PACIFIC EYE ASSOCIATES NEW PATIENT CHECKLIST Download the new patient form prior to your appointment and bring them completed on the day of your examination. Please print clearly and complete
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Start by entering your personal information such as your name, date of birth, and contact information.
02
Proceed to fill out your medical history, including any past and current medical conditions, medications you are taking, and any allergies or sensitivities you have.
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Provide accurate details about your surgical history, including any previous operations you have undergone.
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Include information about your family medical history, including any significant medical conditions that run in your family.
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Patients of all ages and backgrounds may need to fill out this form, regardless of their current health status, as it helps healthcare providers understand their overall health and identify any potential risk factors or conditions.
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medicalhistoryform-new patient5-22-2012doc is a medical history form for new patients dated May 22, 2012.
New patients visiting a healthcare provider are required to fill out the medicalhistoryform-new patient5-22-2012doc.
Patients need to provide accurate information about their medical history, current medications, allergies, and personal health habits on the medicalhistoryform-new patient5-22-2012doc.
The purpose of medicalhistoryform-new patient5-22-2012doc is to gather essential health information about new patients to ensure proper healthcare treatment and management.
Information such as medical conditions, surgeries, allergies, current medications, family medical history, and personal health habits must be reported on the medicalhistoryform-new patient5-22-2012doc.
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