Health History Questionnaire - Word Format
Poor appetite Excessive appetite Change in appetite Fatigue Fevers Night sweats Sweat easily Chills Poor coordination Insomnia Strong Thirst Other:_____ Skin and Hair. past current. Rashes Hives Itching Eczema Pimples Dryness Tumors, Lumps Other:_____ Head/Neck/Eyes/Ears ................
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