Get the Height:Weight:BloodPressure:ReferringDoctor:

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PhysicalTherapyIntakeForm Name: DateofBirth: Height: Weight: BloodPressure: ReferringDoctor: Whatisyourreasonforseekingcare? Whendidtheproblembegin? Whattestsbeendoneforyourcurrentcondition? Haveyouseenadoctororbeenhospitalizedforyourconditioninthepastyear?YesNo
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