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Circle\nPAST MEDICAL HISTORY: Please indicate any major surgeries or hospitalizations, and if there were complications.\nFAMILY HISTORY: Please complete to the best of your knowledge.\nSOCIAL HISTORY: Please answer all questions.\nPhysicians Initials:_________________________\tDate:__________________\nPFSH + ROS Updated:\nUpdated:____________Int:_____/ Updated:____________Int:_______/ Updated__________Int:___________","cbCaitiZUUl3ZyPs","https://ap.wps.com/l/cbCaitiZUUl3ZyPs","doc",36352,"English","# Review of Systems\n## Instructions and Symptom Questions\n## Past Medical History (PFSH)\n## Family History\n## Social History\n## Physician Initials and Date","[{\"question\":\"What does it mean if a question is left blank on this form?\",\"answer\":\"Any question left blank is considered not to be a problem and treated as a “negative response.”\"},{\"question\":\"Where are physician initials and date recorded?\",\"answer\":\"The form includes fields for physician initials and a date.\"}]","Review of Systems Template - 4 | DOC"]