4900 Airport Plaza Drive
Suite 200
Long Beach, CA 90815
Suite 200
Long Beach, CA 90815
(562) 304-5034
(562) 304-5034
FAI Medical History Questionnaire
This form gives our team insight into your child’s medical background so we can customize the plan safely and effectively.
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Be thorough when answering questions about past and current medical issues.
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As with the other forms, enter the patient’s full name and main contact email to ensure proper linkage.
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The form can be revisited at any time via the “Forms” menu or the password link emailed to you.