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OFFICE OF PROSPECTIVE HEALTH EAST CAROLINA UNIVERSITY BRODY SCHOOL OF MEDICINE BASIC HEALTH HISTORY PERSONAL Name ___B#:Date of Birth ___Home Address: ___ City ___ Zip ___ Home Phone ___ Sex:Emergency
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Start by providing personal information such as your name, date of birth, contact information, and insurance details.
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Detail any medical conditions or allergies you may have, along with any prescribed medications.
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Include information on your past surgeries or hospitalizations.
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Mention any family history of medical conditions or hereditary diseases.
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The basic health history formanimal is a document that includes information about the health status and medical history of an animal.
Pet owners or caregivers are required to file the basic health history formanimal for their animals.
To fill out the basic health history formanimal, pet owners need to provide details about their animal's vaccination history, medical conditions, allergies, and any medications they are currently taking.
The purpose of the basic health history formanimal is to keep track of an animal's health information, so that veterinarians and caregivers can provide appropriate care.
Information such as the animal's name, breed, age, weight, vaccination records, medical conditions, allergies, and current medications must be reported on the basic health history formanimal.
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