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Breaking the


Listening  to the WHOLE person...including WHO and WHAT is important to them and WHY

Promoting Behavioral HEALTH by focusing on PREVENTION

Continuum Care Services, Inc.

This questionnaire is an important part of providing you with the best health care possible. Your answers will help in understanding problems that you may have. Please answer every question to the best of your ability unless you are requested to skip a question. Please complete this form and bring it with you to your appointment.