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Smoking Assessment Questionnaire Name: Todays Date: Address: Date of Birth: Smoking History 1. At what age did you begin to smoke? 2. How many cigarettes do you smoke before starting the work day?.

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  2. Type all required information in the required fillable areas. The user-friendly drag&drop user interface makes it simple to add or move fields.
  3. Ensure everything is completed properly, without typos or absent blocks.
  4. Use your electronic signature to the page.
  5. Click on Done to save the alterations.
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