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PLEASE PLACE PATIENT LABEL HERE OR FILL OUT Patient Name: MAN: Scripts Whittier Institute Main Line: (858) 626-5672/ FAX 858-626-7111 Rancho Bernardo (858) 605-7369/ FAX 858-605-7272 Vista (760) 806-5863/
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Diabetes history and assessment is a form that collects information about a person's history with diabetes and evaluates their current health status.
Individuals who have diabetes or are at risk for diabetes are required to file diabetes history and assessment.
To fill out diabetes history and assessment, individuals need to provide accurate information about their medical history, current medications, blood sugar levels, and lifestyle habits.
The purpose of diabetes history and assessment is to monitor and manage the health of individuals with diabetes, as well as to prevent complications associated with the disease.
Information such as medical history, medication list, blood sugar levels, diet and exercise habits, and any symptoms or complications related to diabetes must be reported on diabetes history and assessment.
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