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Wellness Center Health ServicesHealth History220 Pawtucket St., Suite 300 Lowell, MA 018545144 Tel: (978) 9346800Part 1Name: ___ LastMaleFirstStudent ID# ___FemaleTransgenderHome Phone:___Date of
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01
Obtain the form from the Wellness Center at UMass Lowell.
02
Start by filling out your personal information such as your name, date of birth, and contact details.
03
Provide information about your current health condition, any allergies, and any medications you are currently taking.
04
Answer the questions related to your lifestyle choices such as smoking, alcohol consumption, and exercise habits.
05
If applicable, provide details about any medical conditions or previous surgeries you have had.
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Sign and date the form to certify the accuracy of the information provided.
07
Submit the completed form to the Wellness Center for processing.

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Anyone who wants to access the services provided by the Wellness Center at UMass Lowell needs to fill out the form. This may include students, faculty, staff, or other individuals who are seeking wellness services and resources from the center.
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Form wellness centerumass lowell is a document used by UMass Lowell employees to report their wellness activities and participation.
All UMass Lowell employees are required to file form wellness centerumass lowell.
Form wellness centerumass lowell can be filled out online or submitted in person at the wellness center on campus.
The purpose of form wellness centerumass lowell is to track employee wellness activities and promote a healthy workplace.
Employees must report their participation in wellness programs, activities, and any health goals achieved.
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