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MEDICAL HISTORY Name: Last First MI DOB: PRIMARY CARE PHYSICIAN: Name, phone & city EMERGENCY CONTACT: (name & phone # of person not residing with you) Please CIRCLE any condition you HAVE or are
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How to fill out please circle any condition

01
Start by reading the instructions provided.
02
Look for the section that requires you to circle any condition.
03
If there are multiple conditions listed, carefully read each one and choose the appropriate option.
04
Use a pen or pencil to circle the condition that applies to you.
05
Make sure to fill in the circle completely and neatly without extending beyond the boundaries.
06
Double-check your selection to ensure it is accurate.
07
If there are any additional steps or instructions given, follow them accordingly.

Who needs please circle any condition?

01
Individuals who are filling out a form that requires them to indicate a specific condition.
02
People who have a medical condition, allergy, or any other relevant information that needs to be communicated through the form.
03
Any person who is required by an organization, institution, or authority to circle a condition for any purpose.
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Please circle any condition refers to a specific condition that needs to be highlighted or marked.
Anyone who is in charge of completing a form or document that includes the specific condition to circle is required to do so.
To fill out please circle any condition, simply mark or highlight the specified condition by circling it.
The purpose of please circle any condition is to draw attention to a specific condition or requirement.
The information that needs to be reported on please circle any condition would depend on the context or document in which it is being used.
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