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HealthActionsPA. com Women s Health and Not Just Treatment Options Kegels Many gynecologic problems require multidisciplinary treatment. PHYSICIAN REFERRAL PATIENT S NAME D. O. B // PHONE DIAGNOSIS/CHIEF COMPLAINT PRECAUTIONS/COMMENTS EVALUATE TREAT SPECIAL INSTRUCTIONS FREQUENCY/DURATION I CERTIFY THAT PHYSICAL THERAPY SERVICES ARE REQUIRED AND AUTHORIZED BY ME. PHYSICIAN S SIGNATURE DATE Why Choose HealthActions HealthActions Physical Therapy prides itself on staying current with the...
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