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1st Review: 2nd Review: 3rd Review: Demographic Form HHS receives Federal grant money to help sustain our clinics and many of the questions are required by the Grant. Thank you!PART 1 GENERAL/PERSONAL

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Demographic form - health is a form used to collect information about the demographics of individuals related to their health.

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Information such as age, gender, ethnicity, medical history, and any existing health conditions must be reported on demographic form - health.

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