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This document serves as an intake form for patients at Excel Physical Therapy & Rehab, collecting essential medical history, current symptoms, treatment goals, medications, and financial policies related to patient care. It includes sections for body diagram pain mapping, functional limitations, and a privacy policy.

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What is medical history and intake?

Medical history and intake refer to the process of gathering information about a patient's past and present health conditions, medications, allergies, and lifestyle choices to provide appropriate care.

Who is required to file medical history and intake?

Typically, all new patients and those returning for follow-up appointments are required to file medical history and intake forms, as well as any treatments that may change a patient's medical status.

How to fill out medical history and intake?

To fill out medical history and intake forms, patients should provide accurate and comprehensive information about their medical history, current medications, allergies, family health history, and any relevant lifestyle factors.

What is the purpose of medical history and intake?

The purpose of medical history and intake is to ensure that healthcare providers have a complete understanding of a patient's health background, which aids in accurate diagnosis and effective treatment planning.

What information must be reported on medical history and intake?

Information that must be reported includes personal and family medical history, current medications, allergies, previous surgeries, chronic conditions, lifestyle habits, and any other health-related concerns.

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