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Get HEALTH EXAMINATION FORM - Medfusion

Mbers of your family under age 50 had a heart attack or sudden death? Y N Have you ever had any chest pain or passed out while exercising? Y N Do you cough or have trouble breathing during or after exercise? Y N Have you ever had an illness or injury that required hospitalization? Y N Have you ever made repeated visits to a doctor for an illness or injury? Y N Do you have any allergies? Y N Are you presently taking any medications? Y N In the past year, have you had a.

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