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Annual Health Assessment
Click on the link below to access your annual health assessment. Please complete this assessment prior to your January house call visit. Your DRS house call physician will discuss your answers with you during your visit.
Please call 1-877-423-6286 or 248-356-5534 or complete this form
First Name: * Last Name: *
Phone: * Alt. Phone:
Address: Apt# or Bldg #:
City: State: Zip:
Presenting Diagnosis:
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