Ta 6 822 2025

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136 votes

The document outlines a medical assessment form for patients undergoing chemical dependence outpatient services. It includes sections for patient demographics, health history, current medications, immunization status, sleep patterns, withdrawal symptoms, and mental status assessment. The purpose of the assessment is to determine the patient's medical needs and whether they require a physical examination.

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Versions	Form popularity	Fillable & printable
2011	4.8 Satisfied (136 Votes)

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