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Name: DOB: Date: Account Number: Patient Health History and Information Date: Age: Height: Weight: Sex: M F Dominant hand: R L Could you be or are you pregnant: Y Reason for Therapy: Date of injury/onset
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The reason for formrapy is to provide an explanation for a specific action or decision.
Individuals or entities who need to justify their actions or decisions may be required to file a reason for formrapy.
To fill out a reason for formrapy, provide a detailed explanation of the action or decision being justified.
The purpose of reason for formrapy is to provide transparency and accountability for actions or decisions.
The reason for formrapy should include relevant details and justification for the action or decision.
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