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Pure Vida Health Center Medical History Form Please complete this form entirely. All information is strictly confidential. Please print. Name (last, first) Date of Birth (YYY/mm/dd) male female Resident
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Pura Vida Health Centre is a holistic wellness center that offers various alternative health services.
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Any individual or organization who receives services from Pura Vida Health Centre and wants to claim insurance or tax deductions may be required to file.
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The Pura Vida Health Centre form typically requires information such as personal details, services received, dates of service, and insurance information if applicable.
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