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MedicareAnnualWellnessVisitChecklist Pleasecompletethischecklistbeforeseeingyourdoctorornurse. Youranswerswillhelpyoureceivethebesthealthcare possible. PatientName Howoldareyou? ! 6569!7079!80orolderDate

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The acronym SO LDO stands for Statement of Legal Duty Owed.

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Individuals or entities that owe a legal duty to another party are required to file the SO LDO.

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