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Health / Medicine / Wellness / Self-care / Physical exercise


HELEN HAYES HOSPITAL WELLNESS CENTER HEALTH HISTORY FORM Page 1 of 3 Prior to submitting your health history form ensure your doctor agrees that you should be participating in the Wellness Center. The following is a brie
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Document Date: 2013-07-19 16:04:47

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File Size: 108,43 KB

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Company

Microsoft / /

Facility

Wellness Center / Helen Hayes Hospital Wellness Center / Helen Hayes Hospital / /

IndustryTerm

exercise equipment / weight bearing aerobic equipment / car accident / Internet Files\Content.Outlook\6OKTXCY3\WC Participant form / /

MedicalCondition

i.e. osteoporosis / pain / blood clot / osteoporosis / dizziness / autonomic dysreflexia / stroke / heart disease / /

MedicalTreatment

Total Hip Replacement / Knee surgery / surgery / /

OperatingSystem

Microsoft Windows / /

Organization

Helen Hayes Hospital / Wellness Center / Helen Hayes Hospital Wellness Center / /

Position

Physician / aide / MEDICAL CONDITION YES NO PHYSICIAN / /

SocialTag