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Health History Screening Adolescent

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Health History and Screening of an Adolescent or Young Adult Client Save this form on your computer as a Microsoft Word document. You can expand or shrink each area as you need to include the relevant data for your client. Submit this resource with your assignment to the instructor by the end of Module 3. |Student Name: |Date: | |Biographical Data | |Patient/Client Initials: |Phone No: …show more content…

| |Family History | |(Specify which family member is affected.) | |Alcoholism (ETOH use/abuse): | |Allergies: | |Arthritis: | |Asthma: | |Blood Disorders: | |Breast Cancer: | |Cancer (Other): | |Cerebral Vascular Accident (Stroke): |

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