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Bless Chiropractic, 111 SW Columbia, Suite 100, Portland, OR 97201
PATIENT REGISTRATIONEffective Jan.1, 2013 all health care clinics are required to have the following information on file. Please
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How to fill out do you smoke
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Start by obtaining a questionnaire or form that asks about smoking habits.
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What is do you smoke?
Do you smoke refers to a form or questionnaire asking individuals if they smoke tobacco products.
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Any individual who smokes tobacco products may be required to fill out a do you smoke form.
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You can fill out a do you smoke form by answering the questions honestly about your tobacco use.
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The purpose of do you smoke forms is to gather information about individuals' smoking habits.
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Information such as frequency of smoking, type of tobacco products used, and any attempts to quit smoking may be reported on a do you smoke form.
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