DR. WELLHUNG'S PATIENT PRE-EXAMINATION INFORMATION FORM All Patients are required to complete this form prior to scheduling their examination. Your information will be kept in strict confidence. Please use the 'select all' function on your browser, copy this form, paste it into a new text or word document, fill in the blanks (x) to answer all questions, and email it back to me. Thank you, Dr. Wellhung CONTACT INFORMATION Patient name: Patient email: Patient location: PHYSICAL DETAILS Age: ( )years Height: ( )feet ( )inches Build: ( )slim ( )average ( )voluptuous ( )bbw Measurements: ( )br… 阅读更多内容
