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West Hartford Surgery Center  Form

West Hartford Surgery Center Form

Use a West Hartford Surgery Center template to make your document workflow more streamlined.

Products, foods, etc? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If YES, to what? ____________________________________________________________ What type of reaction?: † RASH † HIVES † NAUSEA † SWELLING † TROUBLE BREATHING Do you take any medicines every day? (Including Aspirin, Birth Control Pills, Maalox.) . If yes, Please list below and bring to the...
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