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PEDORTHIC ASSESSMENT FORM - bfootkneebackbbcomb

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The document is a Pedorthic Assessment Form from the Foot-Knee-Back Clinic, detailing patient information collection for foot assessment and orthotic services. It includes sections for personal details, payment policies, health questionnaires regarding current complaints, and consent for information handling. The form outlines fees for assessments and custom orthoses, along with instructions for insurance claims.

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