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Get the free Screening Form 1:18 - Bluegrass Nutrition

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Bluegrass Nutrition Counseling Screening Format Date/Impersonal INFORMATION Name:Sex:Email:Age:Birthdate:(OK for our use only? YES/NO)Address (include City, State, Zip Code): Phone: Primary Secondary
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Start by entering your personal information, such as your name, date of birth, and contact details.
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Provide information about your current health status, including any symptoms you are experiencing and any recent travel history.
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Screening form 118 is typically required for individuals who need to undergo a health assessment or screening process. This may include individuals seeking medical treatment, individuals applying for certain jobs or programs that require health clearances, or individuals who have been in close contact with someone diagnosed with a contagious disease. It is best to consult the specific guidelines or requirements of the organization or entity requesting the form to determine if you need to fill out screening form 118.
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