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HEADACHE QUESTIONNAIREPLEASE FILL OUT IF YOU ARE BEING SEEN TODAY FOR HEADACHES. PLEASE MARK WITH BLACK INK & FILL IN THE CIRCLE COMPLETELY. What is the approximate number of headache days you experience,

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Get a black marker or pen.

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It is especially important for individuals or organizations that need to comply with specific guidelines or regulations.

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Please mark with black means to indicate or highlight using the color black.

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