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Interprofessional Spine Assessment and Education ClinicsPATIENT FOLLOWUP INTAKEName:Date: dd/mm/date of Birth: dd/mm/during the past week, how bothersome have these symptoms been? (please circle to

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Contact your healthcare provider immediately to inform them of your positive test result.

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Anyone who has tested positive for COVID-19 needs to inform their healthcare provider, close contacts, and follow appropriate guidelines for self-isolation and treatment.

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i have tested positive is a declaration or notification of testing positive for a particular condition or disease.

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