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Knee patient evaluation form - Daniel Haber, MD 2025

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The document is a Knee Patient Evaluation Form from Dr. Daniel F. Haber, M.D., designed to collect comprehensive information about a patient's knee issues, including symptoms, pain characteristics, medical history, and previous treatments. It aims to assist in diagnosing and planning appropriate care for knee-related problems.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information at the top of the form, including your name, chart number, age, sex, and which knee is affected.
Indicate how long you have had symptoms and provide the date when this problem began.
In section 1, check all major complaints that apply to you such as pain, swelling, or loss of motion.
For section 2, specify how the problem started by checking all relevant options.
Continue through sections 3 to 28 by answering questions about pain location, mobility issues, treatments received, and any medications taken. Be thorough for accurate evaluation.
Once completed, review your answers for accuracy before submitting the form through our platform.

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