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MALE NEW PATIENT PACKAGE QUESTIONNAIRE & HISTORY Name: ___ Date: ___ Date of birth: ___ Age: ___ Weight: ___ Height: ___ Occupation: ___ Home address: ___ City: ___ State: ___ Zip: ___ Cell Phone:

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Amir Vokshoor MD FAANS is a board-certified neurosurgeon specializing in minimally invasive and complex spine surgery.

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