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FAMILY PRACTICE INITIAL OFFICE VISIT Name: Address: Occupation Phone: (W) Drug Allergies: (H) DEMOGRAPHICS DOB: Age: Sex: City, State: Zip: Referred by: (Cell) Pharmacy #: Race: (for kidney Calculation)
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Start by obtaining the necessary forms or paperwork required for the family practice - initial. This may include personal information, medical history, and any specific concerns or symptoms you want to address.
02
Fill in your personal information accurately and completely. This may include your name, age, address, telephone number, and insurance information. Make sure to double-check the accuracy of your contact details.
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Provide a detailed medical history, including any past illnesses, surgeries, or allergies. It is important to be honest and thorough in disclosing any relevant information to help the healthcare provider understand your medical background.
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Describe your current symptoms or concerns clearly and concisely. Write down any specific details such as the duration, intensity, and any triggers or alleviating factors related to your symptoms. This will help the healthcare provider in making an accurate diagnosis.
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Follow any specific instructions provided on the form regarding additional tests or screenings that may be necessary. If any previous medical records or test results are required, gather and attach them to the form as instructed.
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Review the completed form to ensure all information is accurate and legible. If you have any doubts or questions, seek clarification from the healthcare provider or staff.
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Submit the filled-out family practice - initial form to the designated healthcare professional or office. Keep a copy for your own records, if needed.

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Family practice - initial refers to the initial assessment and documentation of a patient's medical history, current health status, and any present symptoms by a family practice physician.
Family practice - initial is typically filled out by family practice physicians or primary care providers.
Family practice - initial is filled out by conducting a thorough medical history interview with the patient, performing a physical exam, and documenting all findings in the patient's medical record.
The purpose of family practice - initial is to establish a baseline for the patient's health status, identify any potential health concerns, and develop a comprehensive care plan.
On family practice - initial, information such as patient demographics, medical history, current medications, allergies, vital signs, and physical exam findings must be reported.
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