Heart surgery history
[DOC File]Health History Form - little house dentistry
https://info.5y1.org/heart-surgery-history_1_d0b921.html
Medical History. Name:_____ Age:_____ Date of Exam:___/___/___ Date of Birth: ___/____/___ Primary Doctor : _____
[DOC File]HEALTH HISTORY - ProSites, Inc.
https://info.5y1.org/heart-surgery-history_1_cd85c4.html
Heart Surgery Emphysema Liver Disease. Mitral Valve Prolapse Epilepsy or Seizures Hemophilia. Heart Murmur Anemia Kidney Disease. Heart Disease or Attack Ulcers Venereal Disease/STDs. Artificial Heart Valve Tuberculosis (TB) Glaucoma ... Family History of Cardiovascular Disease Fainting or Dizzy Spells Cortisone Medication. Heart Failure Any ...
[DOC File]HEALTH HISTORY - ProSites, Inc.
https://info.5y1.org/heart-surgery-history_1_c149d0.html
Heart Problems. Heart attack Date: _____ History of heart surgery Date:_____ High blood pressure. Heart murmur. Heart valve problem. Taking heart medication. Rheumatic fever. Pacemaker. Bone or Joint Problems. Arthritis. Joint replacement Date:_____ Has a physician recommended antibiotic premedication for your dental appointments? ...
[DOC File]Mid – Valley Cardiology
https://info.5y1.org/heart-surgery-history_1_0e7ca3.html
HEALTH HISTORY. Name _____ Date _____ ... No Yes Slow-Healing Mouth Sores No Yes Previous Bacterial Endocarditis No Yes Unintentional Weight Loss/Gain No Yes Heart Valve (artificial) or Heart Transplant No Yes H.I.V. Infection/AIDS or ARC No Yes Congenital Heart Disease No Yes Venereal Disease No Yes Heart Disease, Heart Attack, Heart Surgery ...
Cardiac surgery - Wikipedia
heart surgery before age 55 (father or brother) or blood pressure (>140/90) or take medication before age 65 (mother or sister) _____ You are > 20 pounds overweight _____ You smoke, or quit within the previous 6 months.
[DOC File]HEALTH HISTORY QUESTIONNAIRE
https://info.5y1.org/heart-surgery-history_1_22dd69.html
Title: HEALTH HISTORY Author: Jon & Kathy Samaha Last modified by: Jacinda Piroso Created Date: 6/22/2011 2:44:00 PM Company: Jon & Kathy Samaha, D.M.D.'s
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