American Society of Hand Therapists (ASHT)

Ligament Damage. ff. Wrist Pain. l. Dislocation. Part of Body Injured: a. Abdomen. o. Hand(s) aa. Neck. b. Ankle(s) p. Head. bb. Nervous System ... Driver’s Name (if different than above) & Phone #: License NO. & State: For Auto Damage, Shade the Specific areas damaged: Description of Incident To be completed for all incidents Describe in ... ................
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