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Health History and Consent to Health Care Form

Health History and Consent to Health Care Form

Use a Health History And Consent To Health Care Form template to make your document workflow more streamlined.

Allergies To foods list To medications list To the environment insect stings hay fever etc. list Other allergies list Dietary restrictions list Describe previous reactions Explain/describe if Participant has a need for an or Epinephrine What Have We Forgotten to Ask Please provide in the space below any additional information about the Participant s health that you think important or that may affect the Participant s ability to fully participate in the program. Attach additional information if...
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