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Mariam Nazi, M.D. 361 Hospitality Rd. Suite 227 Newport Beach, CA. 92663 Tel: (949) 4367294 Fax: (877) 78739198HEALTH HISTORY QUESTIONNAIRE All questions contained in this questionnaire are strictly

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Dr. Mariam Razi is a form used for reporting certain financial information to the tax authorities.

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Dr. Mariam Razi typically requires reporting of income, expenses, deductions, and other financial details.

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