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  • Pre-Participation Physical Evaluation

    Physical Examination Form-Valid for 2 Years
  • Medical History

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    Pick a Date
  • Patient Health Questionnaire Version 4 (PHQ-4)

  • Over the last 2 weeks, how often have you been bothered by any of the following problems?

  • Explain "Yes" answers at the end of this form.

  • I hereby state that, to the best of my knowledge, my answers to the questions on this form are complete and correct.

  • Clear
  • Clear
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    Pick a Date
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  • Should be Empty: