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THE LA JOLLA INSTITUTE OF PLASTIC SURGERY James Kashmir Pietraszek, M.D., F.A.C.S.BREAST SURGERY QUESTIONNAIRE Please complete this form in order to assist Dr. Pietraszek in discussing your surgical
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How to fill out breast surgery questionnaire
How to fill out breast surgery questionnaire
01
Start by reading all the questions on the breast surgery questionnaire carefully.
02
Provide accurate and honest information about your medical history, previous surgeries, and current health conditions.
03
Include details about any medications you are currently taking or allergies you may have.
04
Be specific about your goals and expectations for the breast surgery procedure.
05
If you have any concerns or questions, don't hesitate to ask the healthcare provider for clarification before filling out the questionnaire.
Who needs breast surgery questionnaire?
01
Individuals who are considering undergoing breast surgery.
02
Patients who have been advised by their healthcare provider to undergo breast surgery.
03
People who want to provide their healthcare provider with detailed information about their medical history and expectations for the surgery.
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What is breast surgery questionnaire?
A breast surgery questionnaire is a form that gathers information about a patient's medical history, surgical procedures, and personal information related to breast surgery.
Who is required to file breast surgery questionnaire?
Patients who are undergoing or have undergone breast surgery are required to fill out and file a breast surgery questionnaire.
How to fill out breast surgery questionnaire?
To fill out the breast surgery questionnaire, patients must provide accurate and detailed information about their medical history, previous surgeries, and any relevant personal information.
What is the purpose of breast surgery questionnaire?
The purpose of the breast surgery questionnaire is to gather necessary information for medical professionals to provide appropriate care and treatment for patients undergoing or having undergone breast surgery.
What information must be reported on breast surgery questionnaire?
Information such as medical history, previous surgical procedures, allergies, medications, and contact information must be reported on the breast surgery questionnaire.
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