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Orange Coast Women's Medical Group Bone Density Patient Questionnaire NAME: DATE OF EXAM: ORDERING DOCTOR: DOB: 1. Your ethnicity (check one, this information is used to calculate your fracture risk):
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How to fill out Orange Coast Women's Medical:

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Start by reading through the form carefully. Make sure you understand all the sections and questions before beginning.
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Begin by providing your personal information, such as your full name, date of birth, and contact details. Ensure that you double-check the information for accuracy.
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In the next section, indicate your current health insurance information. This may include the name of your insurance provider, policy number, and any additional details required.
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Proceed to answer the medical history questions. This typically involves providing information about any past surgeries, current medications, allergies, and any chronic conditions you may have.
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The form may also ask about your family medical history. Fill in any relevant information about your immediate family members' health conditions, if applicable.
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Provide details about your current symptoms or reason for seeking medical care. Be as specific and accurate as possible to help the healthcare provider assess your needs effectively.
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If applicable, indicate your preferred pharmacy for prescription purposes.
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Who needs Orange Coast Women's Medical?

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Women of all ages who require comprehensive medical care specifically designed for women's health.
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Those seeking a reputable and experienced women's medical center that offers a wide range of services.
Note: It is important to consult with a healthcare professional or directly contact Orange Coast Women's Medical for specific eligibility and requirements.
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Orange Coast Women's Medical Group is a healthcare facility that specializes in providing medical services for women.
Patients who receive medical services from Orange Coast Women's Medical Group are required to file their medical information with the facility.
Patients can fill out Orange Coast Women's Medical forms by providing accurate and complete medical information about themselves.
The purpose of Orange Coast Women's Medical forms is to ensure that the healthcare facility has necessary information to provide appropriate medical services to its patients.
Patients must report their personal information, medical history, current medical conditions, and any medications they are taking on Orange Coast Women's Medical forms.
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