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Champlain Medical Urgent Care Enlist allergies you have:Patient Name: ___ YesNoDrug Allergies (specify):Do parents/siblings have any of the following? Cancer or Leukemia: Diabetes:List medications

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blogchamplain medicalburlington vt urgent is a form that needs to be filled out by individuals seeking urgent medical care at Champlain Medical Clinic in Burlington, Vermont.

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