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Viol and Minerva, P.A. 5024 Dorsey Hall Drive, Suite 103Ellicott City, MD 21042Physical Therapists Phone: 410 740 1047Fax: 410 7402280Herdman Dizziness Questionnaire1 Name: Age: Date: Present Occupation:
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To fill out VertigoDoc, follow these steps:
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Open the VertigoDoc form in your web browser.
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Start by entering your personal information, such as your name, address, and contact details in the designated fields.
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Provide any relevant medical history, including past illnesses, surgeries, and medications you are currently taking.
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Answer the specific questions related to your symptoms or condition as accurately as possible.
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If applicable, provide information about any recent injuries or accidents that may have led to your vertigo.
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Review the completed form for any errors or omissions.
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Once satisfied, submit the form electronically or print it out if a physical copy is required.
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Make sure to follow any additional instructions provided by the healthcare provider or organization requesting VertigoDoc.

Who needs vertigodoc?

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VertigoDoc can be useful for individuals experiencing symptoms of vertigo or dizziness. It may be needed by:
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Patients seeking medical advice or treatment for their vertigo symptoms.
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Individuals undergoing evaluation or assessment for vertigo-related disorders.
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Healthcare providers or specialists requiring comprehensive patient history and symptoms documentation.
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Employers or occupational health services screening individuals for workplace safety or fitness assessments.
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