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FMC Medical Clinic MillportNEW PATIENT (ADULT) HEALTH HISTORY Page 1 of 3TODAYS DATE: Reason for Visit Today: CURRENT MEDICATIONS (prescriptions AND overthecounter) MedicationDoseFrequencyWho prescribed
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Druid City Family Medicine is a medical practice that offers primary care services to families in the community.
All patients who receive medical services from Druid City Family Medicine are required to file their medical history and information.
To fill out Druid City Family Medicine forms, patients need to provide accurate information about their personal medical history, current medications, and any existing health conditions.
The purpose of Druid City Family Medicine is to provide comprehensive and compassionate medical care to individuals and families in the community.
Information such as personal medical history, current medications, allergies, family medical history, and any existing health conditions must be reported on Druid City Family Medicine forms.
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