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Tracy Hews, DO Jennifer Denton, INPATIENT INFORMATIONHoos Pediatrics 904 W Ocmulgee Muskogee 74401 9189107991(PLEASE PRINT & Fill Out Completely)Date: ___ Patient\'s Name: First ___ Middle___ Preferred
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Obtain a copy of the Hoos Pediatric and Adolescent form.
02
Fill out the patient's demographic information including name, date of birth, and contact information.
03
Provide information about the patient's medical history, including any pre-existing conditions or medications they are taking.
04
Answer the questionnaire regarding the patient's physical activity level, dietary habits, and sleep patterns.
05
Complete the form by signing and dating it as the parent or legal guardian of the patient.

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Parents or legal guardians of pediatric and adolescent patients who want to provide comprehensive health information to healthcare providers
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Hoos pediatric and adolescent is a form used to report medical information for children and teenagers.
Healthcare providers who treat pediatric and adolescent patients are required to file hoos pediatric and adolescent.
Hoos pediatric and adolescent can be filled out online or on paper, following the provided instructions and including all required medical information.
The purpose of hoos pediatric and adolescent is to ensure accurate and comprehensive reporting of medical information for pediatric and adolescent patients.
Information such as patient demographics, medical history, current medications, and treatment plans must be reported on hoos pediatric and adolescent.
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