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Medical Intake Form Please select each of the topics that relate to your medical history: Anemia A pacemaker Allergies Back Pain Angina Asthma Bronchitis Blood Clot/Emboli Bowel/Bladder problems Drink

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How to fill out print clearly and fill

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3. Fill out all sections completely and accurately.
4. Avoid using abbreviations or symbols that may be misunderstood.
5. Take your time and write neatly to make the information easily readable.

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Print clearly and fill refers to the process of completing a form or document by filling it out legibly, ensuring that all information is clear and easy to read.

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The information reported typically includes personal details, financial information, and any other specific data mandated by the governing authority for that form.