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EPWORTH SLEEPINESS SCALE PATIENT NAME AGE DOB TODAYS DATE Using the scale provided, please answer how likely you are to doze off or fall asleep in the following situations, if you allowed yourself
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How to fill out patient nameage dob todays
How to fill out patient nameage dob todays
01
To fill out the patient name, you need to provide the first and last name of the patient.
02
To fill out the patient age, you need to enter the age of the patient in years.
03
To fill out the patient date of birth (DOB), you need to provide the exact date of birth of the patient.
04
To fill out 'today's date', enter the current date when the form is being filled out.
Who needs patient nameage dob todays?
01
Medical professionals, healthcare providers, or anyone involved in patient record-keeping may need to fill out the patient name, age, DOB, and today's date.
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