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LOGANVILLE FAMILY & SPORTS MEDICINE:DATE: Name: Date of Birth: Age: Male / Female (circle one) Pregnant Yes / No (circle one) Reason you are here: SOCIAL HISTORY Marital Status: Single Married Partner
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What is loganville family medicine?
Loganville Family Medicine is a medical practice that provides care for individuals and families in the Loganville area.
Who is required to file loganville family medicine?
Medical professionals or administrators responsible for managing the practice.
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The form can be filled out online or in person at the office of Loganville Family Medicine.
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Patient demographics, medical history, current medications, allergies, and any other relevant medical information.
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