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MedicalHistory/PhysicianRelease Pleasecompletethisformasthoroughlyaspossible. Foritemsthatarenotapplicable, pleasewriteN/A. Client/patientName: Age DateofBirth: Checkthefollowingareasofconcernforthisclient.
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How to fill out foritemsthatarenotapplicablepleasewritena - centaurstride:
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