WitrynaPast Medical History and Review of Systems: Please check off if you have had any problems with or are presently experiencing any of the following: Alcohol abuse Depression Hepatitis or jaundice Pneumonia Abdominal discomfort Diarrhea High Blood Pressure Rheumatic fever Anemia Diabetes High Cholesterol Shortness of breath ... WitrynaMedical Group 6675 Westwood Blvd, Suite 475, Orlando, FL, 32821. Office Phone: (407) 845-0330 • Fax: (866) 914-1818 ... I authorize IMA MEDICAL GROUP to release the health information indicated below to: Yo autorizo a IMA MEDICAL GROUP a proporcionar la informacion de salud como se indica a
Medical Group Office Phone: (407) 845-0330 • Fax: (866) 914-1818
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