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F218Registrant Personal/Medical HistoryCreated 03/02 Revised 09/18Sergei Y. Gorbachev, Director September 2018Approved this form is provided in the Registrant packets and is completed by the Registrant
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Start by obtaining the registrant personalmedical history form.
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Fill in the registrant's personal information such as name, date of birth, address, and contact information.
03
Provide details about the registrant's medical history including any past illnesses, surgeries, medications, and allergies.
04
Include information about any current medical conditions or ongoing treatments.
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Registrant personal medical history is a record of an individual's past and current medical conditions, medications, allergies, surgeries, and other relevant health information.
Registrants or individuals who are seeking medical treatment or services are required to file their personal medical history.
Registrants can fill out their personal medical history by providing accurate and detailed information about their health conditions, medications, allergies, surgeries, and other relevant health information on the provided form.
The purpose of registrant personal medical history is to provide healthcare providers with essential information about an individual's health status, which helps in making informed medical decisions and providing appropriate treatment.
Registrants must report their past and current medical conditions, medications, allergies, surgeries, family medical history, and any other relevant health information.
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