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Get Highland OB/GYN Patient Medical History Form 2012-2024

R (specify) ______________ ________ Or None â–¡ Year PAP SMEAR / MAMMOGRAM HISTORY Date of last PAP smear: _____________________ Date of last Annual Wellness Exam: __________ Have you ever had an abnormal pap smear? Yes â–¡ No â–¡ Have you ever had treatment for an abnormal pap smear? Yes â–¡ No â–¡ If yes, what type(s) of treatment have you had? Check all that apply: Or None â–¡ Cryotherapy Yes â–¡ No â–¡ Cone biopsy Yes â–¡ No â–¡ Colposcopy Yes â–¡ No â–¡ Loop excision (LEEP) Yes â–¡ No â–¡.

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