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THANK YOU FOR COMPLETING YOUR HEALTH HISTORY FORMS

NOW, HELP US SEE THE FULL PICTURE

Many people come to us with symptoms that don’t exist in isolation.

This optional Systems Survey allows you to share how different areas of your health may be affected or connected — even if those symptoms don’t seem related. Patients often tell us it helps them feel more understood and leads to a more focused, productive visit.

We invite you to take a moment to complete this survey, as it helps us better understand what’s going on and allows you to get more out of your care. If you’re short on time, you’re welcome to skip it or answer only what applies.

YOUR BODY KNOWS WHAT IT NEEDS—LET’S LISTEN TO IT

515-612-8489

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