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City Raleigh / Greensboro / Durham / / Company Oriental Health Solutions LLC / LG / / Currency USD / / Event Product Issues / Product Recall / / Facility Durham Freeway / Club Blvd / / IndustryTerm law enforcement purposes / insurance plan / insurance claim forms / insurance reimbursement / insurance / risk management / flax seed oil / food / olive oil / federal law / chemicals / insurance carrier / cognitive processing / / MedicalCondition Tolerance Fearful Suicidal Tremors / celiac disease / HIV / Pelvic Inflammatory Disease / inconsistent bowel movements Increased bloating / Heart disease / foods Constipation / Miscarriages / communicable disease / Numbness / injury / complaints Musculoskeletal Neck Pain Back Pain Hand/Wrist Pain Elbow Pain Arm Pain Shoulder Pain Rib Pain Hip Pain Knee Pain Foot/Ankle Pains Hernia Pain Deformities / Dry Skin Acne Ulcerations Infections / burns / tiredness / IR Fatigue / light-headedness / serious diseases / Hypertension / Cancer / disease / Libido Hot Flashes Night Sweats Sexually Transmitted Disease HPV / hypothyroidism / aches / Diabetes / Menstrual Pain Clots PMS Polycystic Ovarian Disease / pollutants Brain fatigue / mental speed Brain fatigue / pain / infection / inflammation / nerve pain / No Vaginal Discharge / / MedicalTreatment Birth Control / Vegetarian diet / complementary medicine / dietary supplements / Chiropractic / imagery / acupuncture / counseling / physical therapy / massage / cold therapy / hypnosis / herbal therapy / / NaturalFeature Chapel Hill / / Organization Food and Drug Administration / Family / / Person Injury Bad / Night Sweats Fevers / Injury Bad Temper Worry / / / Position Secretary of Health / Tics Poor Memory/Concentration Anxiety Sadness Weepy Depression Paralysis Mental Illness General / personal representative / licensed physician / Numbness Head / Current Physician / Urine Cloudy Urine Head / / Product Depo-Provera / Decrease / mental performance Increased ability / / ProvinceOrState North Carolina / / Region Eastern Virginia / / Technology Antibodies / / SocialTag 
Oriental Health Solutions, LLC - OHS CF-1402 New Patient Questionnaire PATIENT DATA: Date:__________________