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Updated July 25 23MEDICAL STATUS FORM RESIDENTIAL Tel: 9055238852 ext. 123 Fax: 9055238211 Email: admissions@hiro.ca Web: www.hiro.caTO BE COMPLETED BY PHYSICIAN OR NURSE PRACTITIONER Is this applicant
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Obtain the medical status form from the community center or online.
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Fill out your personal information accurately, including name, address, contact number, and date of birth.
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Provide details about your medical history, including any current medications, allergies, and previous surgeries.
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Answer all questions honestly and to the best of your knowledge.
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Members of the community who are seeking medical services or participating in community events may need to fill out a medical status form.
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The medical status form-community is a document that collects health-related information from individuals in a community to assess their medical conditions and needs.
Individuals residing in the community who are seeking healthcare assistance, benefits, or services are typically required to file the medical status form.
To fill out the medical status form-community, you should provide accurate personal details, medical history, current health status, and any other required documentation or information as specified on the form.
The purpose of the medical status form-community is to gather essential health information to facilitate appropriate medical care, resource allocation, and support services within the community.
The medical status form-community typically requires reporting personal identification information, medical history, current medications, allergies, and contact information for healthcare providers.
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