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CONFIDENTIALDENTAL MEDICAL HISTORY FORM FOR PATIENTS UNDER 18 YEARS OF AGED ATE Patients Name Sex Age DOB Home Phone Number Email Address City Zip Any Siblings? Ages Other Family Members Treated School

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How to fill out under 18 mh both

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Step 1: Obtain the under 18 mental health both form from the concerned authorities or online platforms.

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Step 3: Fill in personal details such as name, age, address, and contact information in the designated sections.

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Step 4: Provide accurate information about the mental health condition of the individual under 18 years old.

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Step 5: Answer the questions regarding the symptoms, duration, and severity of the mental health condition.

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Step 6: If applicable, provide any relevant medical history or previous treatment information.

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Under 18 mh both is needed by individuals who are under the age of 18 and have a mental health condition.

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Parents or legal guardians of minors with mental health issues may also need to fill out this form on behalf of the child.

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