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Medical History
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Physicians involved in patient's care
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surgical history
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Family History
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Family history of breast cancer
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Family history of uterine cancer
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Family history of ovarian cancer
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Family history of colon cancer
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Details of family history with osteoporosis
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Family history of cardiovascular diseases
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Family History - additional comments
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Social History
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Marital Status
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Occupation
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Alcohol intake
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Tobacco
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Patient's diet
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Caffeine intake
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exercise programs
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Does patient have any sleep problems?
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Stress level:
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stressors
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Comments
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