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SOCIAL HISTORY
Name: ___Date: ___TOBACCO
Never a Smoker
Current Smoker amount per day ___
Former Smoker Date Quit ___ Years Smoked ___
Chewing Tobacco ___
ALCOHOL USE
Does not drink daily # per day
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What is social history formdocx?
Social history formdocx is a document used to gather information about an individual's background, lifestyle, and social environment.
Who is required to file social history formdocx?
Social history formdocx is typically required to be filled out by individuals seeking medical treatment or counseling services.
How to fill out social history formdocx?
To fill out social history formdocx, individuals need to provide accurate and detailed information about their past and current social circumstances.
What is the purpose of social history formdocx?
The purpose of social history formdocx is to help healthcare providers and counselors better understand the factors that may be influencing an individual's health or well-being.
What information must be reported on social history formdocx?
Information such as family background, living situation, employment status, education level, and substance use may need to be reported on social history formdocx.
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