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Medical Questionnaire for Returning Patient 

Please fill out the following form

Have you been hospitalized OR Have you had any changes in your health status since last consultation, such as new diagnosis of high blood pressure, thyroid or cardiac issues or others??
Have experienced any side-effects from the medications since last consulation?
Since last consultation, was your blood pressure:

Thanks for submitting!

Do not forget to schedule your REFILL appointment for medication pick-up


Text us to double book if unable to book online

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