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CARDIOLOGY QUESTIONNAIRE Name: Date: Date of Birth: Age: Marital Status: Single Married Divorced Widow/Widower Why were you referred for a cardiac evaluation? Review of Systems: (Please Circle) Fever
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How to fill out the cardiology questionnaire - LVHN:

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Start by carefully reading each question on the questionnaire to ensure you understand what information is being requested.
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Provide accurate and complete answers to each question. It is important to be as detailed as possible to facilitate accurate diagnosis and treatment.
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Review your answers before submitting the questionnaire to ensure that you haven't missed anything or made any mistakes.

Who needs the cardiology questionnaire - LVHN:

01
Individuals who have been referred to a cardiology department or healthcare provider at LVHN.
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Patients who are experiencing symptoms related to cardiovascular health, such as chest pain, shortness of breath, or palpitations.
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Individuals with a history of heart disease, high blood pressure, or other cardiac conditions.
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People who have undergone previous cardiac procedures or surgeries.
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Patients who have a family history of cardiovascular disease or risk factors.
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Individuals who are seeking preventive care or cardiovascular risk assessment.
It is important to note that it is always best to consult with a healthcare professional or follow the instructions provided by LVHN specifically for filling out their cardiology questionnaire.
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The cardiology questionnaire - lvhn is a form used to gather information about a patient's cardiac health for the Lehigh Valley Health Network.
Cardiologists, healthcare providers, or patients themselves are required to fill out the cardiology questionnaire - lvhn.
The cardiology questionnaire - lvhn can be filled out online or in person with the assistance of a healthcare provider.
The purpose of the cardiology questionnaire - lvhn is to assess the cardiac health of patients and provide necessary medical treatment.
Information such as medical history, current medications, symptoms, and family history of cardiac issues must be reported on the cardiology questionnaire - lvhn.
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