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DERMATOLOGISTS OF SOUTHWEST OHIO, INC. MEDICAL HISTORY FORM PATIENT INFORMATION Name: Date of Birth: Latex allergy? Any drug allergies? Yes Yes No Account #: If yes, list any drugs you are allergic
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Dermatologists of Southwest Ohio is a group of dermatology professionals practicing in the region of Southwest Ohio.
All dermatology professionals practicing in Southwest Ohio are required to file.
Dermatologists of Southwest Ohio can be filled out online or by submitting a physical form provided by the regulating body.
The purpose of dermatologists of Southwest Ohio is to ensure that all dermatology professionals in the region are practicing ethically and within the guidelines set by the regulating body.
Information such as contact details, qualifications, current practice status, and any disciplinary actions must be reported on dermatologists of Southwest Ohio.
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