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Jun 4, 2019 · I decided to come to ReforMedicine Medical Weight Loss to help me with my weight because: _____ My weight at age 20 was _____ lb. My Weight one year ago was:_____ lb. …
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WEIGHT LOSS PROGRAM CONSENT FORM I, _____, authorize Weight No More providers, to help me in my weight-reduction efforts. I understand that my program may consist of a …
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- Obesity Related Health Problems: Metabolic - Diabetes, high blood pressure, high cholesterol Cardiovascular - heart disease and Stroke GI - acid reflux, gallbladder disease, fatty liver Respiratory - Sleep Apnea, worsening asthma, hypoventilation syndrome, dyspnea on exertion Musculoskeletal - arthritis, aches and pains, gout Dermatological - stret...
Weight Loss Program Consent Form. I, _____, (patient/guardian) do hereby authorize Dr. Holloway and staff, to assist me with weight reduction. I fully understand that this program …
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Weight Loss Program Consent Form I, ______________________________________ authorize Dr. and whoever is designated as this physician’s assistant, to help me in my weight reduction …
Has your doctor advised you to lose weight? Do you have any dietary restrictions? Please explain: How often do you exercise? What type of exercise? Do you feel stressed? Please explain: …
Weight Management Program I understand the University of Michigan Weight Management Program (WMP) is a 2-year (24 months) comprehensive program designed to help me reach …
Weight Loss Contract - Dr. Gish
Jan 25, 2015 · A weight loss program that works should include: proper nutrition, exercise, and portion control. This weight loss contract is an agreement between the patient and the physician to commit to a long-term goal of attaining a …
When you decided to learn more about managing your weight, you took an important step toward improving your health. The health professional who is advising you can help you develop …
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