Med HX Body Pain ADL Form.doc 2025

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4.9 out of 5

35 votes

The document is a medical history and pain assessment form for a patient, detailing their diagnosis, treatment history, current medications, and various health conditions. It includes questions about the onset of pain, previous hospitalizations or surgeries, and the impact of pain on daily activities. The patient is asked to rate their pain levels and indicate any difficulties with personal hygiene and work activities.

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