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DTI×1603/2012 Thermographic, the safe way to screen BreastThermographyConfidentialQuestionnaire Name: DOB: PAID# Allinformationgiveninthequestionnairewillremainstrictlyconfidentialandwillonlybedivulgedtothereportingthermologistandanyother

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Formrmography form safe way is a document used to report safety measures and protocols in place to ensure a safe working environment.

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