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WWW.drnatechiro.com9549385959Dr. Nate Greenspan Patient Symptom Survey (Page 1 of 2) Name: Date: Please circle the appropriate number 03 on all questions below. 0 as the least/never to 3 as the most/always
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To fill out the please circle form appropriately, follow these steps: 1. Read the instructions carefully to understand the purpose of the form. 2. Determine which sections require circling the appropriate options. 3. Use a pen or pencil to mark the circle completely and neatly for each desired option. 4. Make sure you do not cross or make multiple circles for a single question. 5. Double-check your answers to ensure you have circled the correct options. 6. Review the entire form to make sure you have completed all necessary circles. 7. Once you are satisfied with your answers, submit the form as instructed.

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