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Garner Family Practice 801 Poole Drive Garner, NC 27529HEALTH HISTORY ASSESSMENTDate: Primary Care Physician: Patient Name: Date of Birth: Address: City: State: Zip: Home Phone# Work Phone # Mobile
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To fill out the Garner Family Practice form, follow these steps:
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Start by providing your personal information such as your full name, date of birth, and contact details.
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Next, indicate your current address and any previous addresses if applicable.
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Provide your insurance information including the name of the insurance company and your policy number.
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In the medical history section, answer the questions regarding your past and current medical conditions, medications, and allergies.
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If you have a preferred pharmacy, indicate its name and location.
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Finally, sign and date the form to complete the process.

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Whether you require primary care, annual check-ups, preventive screenings, or treatment for acute or chronic conditions, Garner Family Practice can provide the necessary healthcare services.

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Garner Family Practice is a medical practice that offers healthcare services to individuals and families.
Patients who have visited Garner Family Practice are required to file their medical history and any relevant information about their health.
To fill out Garner Family Practice forms, patients need to provide accurate information about their medical history, current health conditions, and any medications they may be taking.
The purpose of Garner Family Practice is to provide comprehensive healthcare services to patients, including diagnosis, treatment, and preventative care.
Information reported on Garner Family Practice forms may include patient demographics, medical history, current health concerns, medications, allergies, and any recent treatments or surgeries.
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