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Patient Info Online Form

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I have a couple of questions on the form as I am sitting here filling out the

copy I printed (then I will go in online and fill it in)..anyway..there is a

space that saysDescribe your hospitalizations or surgery and one that says

Detailed Description of your diets. Both of these have a box next to it like

I am supposed to type something but below there has spaces to fill in the

diets and surgeries. So am I supposed to just fill those in or also write a

synopsis on them too. I am a little confused. Other than that I have it all

filled in except my waist measurement...I don't have a measuring tape and my

Ins. Co fax number which I can't get til Monday. Any help is appreciated!

Holly in Illinois

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