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HISTORY AND PHYSICAL PATIENTS NAME: ___DATE:___AGE: ___ HEIGHT: ___ WEIGHT: ___ The following questions are to be filled out by the patient. Check box YES or NO. Any positive response will be discussed
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dr-atkins-patient-forms-backpdf is a form used for patient information related to Dr. Atkins.
Patients of Dr. Atkins or individuals providing patient information.
The form can be filled out manually or electronically, following the instructions provided on the form.
The purpose is to collect and record patient information for Dr. Atkins' records.
Personal and medical information of the patient as requested on the form.
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