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ALAMO MENTAL HEALTH GROUP PATIENT HISTORY First Name: Last Name: Gender: Age: Date of Birth: Guardian: Home Address: Telephone number: Reason for visit: Do you have a drug or alcohol abuse problem?.

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  3. Fill in the blank fields; involved parties names, places of residence and phone numbers etc.
  4. Customize the template with smart fillable fields.
  5. Add the date and place your e-signature.
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