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WESTERN WAKE WELLNESS, LLC PEDIATRIC REGISTRATION401 KESSLER DRIVE SUITE 101 CARY NC 27518 9193781492 www.WesternWakeWellness.comPATIENT INFORMATION Legal Name:___ Nickname:___ Today's Date:___ Date

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Step 1: Collect all necessary information such as personal details, medical history, and current symptoms.

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Step 2: Visit the Western Wake Wellness website or contact their office to obtain the Western Wake Wellness form.

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Western Wake Wellness is a health initiative aimed at promoting physical and mental well-being in the Western Wake area through various programs and services.

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Individuals and organizations participating in health programs or services related to Western Wake Wellness may be required to file reports or documentation.

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The purpose of Western Wake Wellness is to improve community health outcomes by encouraging healthy behaviors and providing access to wellness resources.

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Information that must be reported includes participant demographics, health program engagement, and outcomes of wellness activities.

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