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PATIENT HEALTH HISTORY

By providing my email address I authorize my doctor to contact me via the email address provided.

Please check those that apply to your Medical History.

Have you had trouble with any of the following (please mark each one with present, past, or no):

Cardiovascular:

Genitourinary:

Hematologic/lymphatic:

Neurologic:

Respiratory:

Ears/Nose/Throat:

Eyes:

Integumentary:

Psychiatric:

Constitutional:

Allergic/Immunologic:

Gastrointestinal:

Musculoskeletal:

Endocrine:

THIS ---->https://paolachiro.com/new-patient-center/health-history-form.html

Office Hours

Day
Monday8 - 6
Tuesday8 - 3
Wednesday8 - 6
Thursday8 - 11
Friday8 - 6
SaturdayClosed
SundayClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8 - 6 8 - 3 8 - 6 8 - 11 8 - 6 Closed Closed

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