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Get and Sign Orthopaedic Institute of Ohio Orthopaedic Surgeon Lima, OH 2014-2022 Form

Get and Sign Orthopaedic Institute of Ohio Orthopaedic Surgeon Lima, OH 2014-2022 Form

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Totals Female Male Administration On initial visit Prior to Opioid therapy ADO attention-deficit disorder OCD obsessive-compulsive disorder Scoring 0-3 low risk 6 4-7 moderate risk 28 8 high risk 90 Physician Signature Date. Where is the pain located eg right side of neck 6. Mark the areas on your body where you feel pain. 7. Which treatment helped 17. Past medical history check all that apply diabetes Asthma/COPD fibromyalgia depression cardiac defibrillator high blood pressure heart...
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