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Medical History: Cancer? Diabetes? High Blood Pressure? Heart Disease? Osteoporosis? Osteoarthritis? Rheumatoid arthritis? Neurologic dz (MS, Parkinsons)? Ulcers / GERD / Acid Reflux? Kidney / Liver Disease? Prior Surgeries: MOS/Occupation: Duty Station/Unit: When did symptoms start (date): Symptoms related to deployment? Yes-Combat Yes-NonCombat No Have you had these symptoms before? Yes No How did symptoms start? Symptoms are? Constant Come/Go Only with Activity S.

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  3. Go through the recommendations to determine which details you must give.
  4. Click the fillable fields and include the requested data.
  5. Put the date and place your e-signature once you complete all other boxes.
  6. Examine the document for misprints along with other mistakes. If there?s a need to correct some information, the online editor and its wide range of instruments are at your disposal.
  7. Save the resulting form to your computer by clicking on Done.
  8. Send the electronic document to the intended recipient.

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