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Medicine

Medical History Form 

Medical History & Medication Form

Please fill out this form with details of your medical history and current medications. For medications, if possible, include both the name of the drug and the condition it is treating. You can also find common alternatives and main salts for reference.

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For a comprehensive list of common allergens and how they might affect you, please visit this page to learn more about potential allergens, how to recognize them, and the precautions we can take to ensure your well-being.

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Do you have any of the following conditions?
Do you have any known allergies?
Are you currently taking any medications?
Psychiatric medications are grouped based on the conditions they treat and their mechanism of action. Below are the primary categories:
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