Annual Preventive Physical Women over 50 - Alaska Family Care

Annual Preventive/Physical WOMEN under 50. Name: _____ Today’s Date: _____ Age: _____ Date of Birth: _____ Date of last exam: _____ This is a preventive health care physical exam and will be billed as such. Please understand that insurance coding cannot be changed after the visit. It is your responsibility to know if your insurance covers a ... ................
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