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Dr Lisa MarksLevel 4, 18 North TerraceAdelaide SA 5000Ph 08 8213 1800 MEDICAL HISTORY QUESTIONNAIRE LEG VEIN ASSESSMENT Please take a few minutes to answer the following questions carefully as this assists us in preparing foryour assessment. The information from this Questionnaire may be used for research purposes. Your personal details will be withheld. Please tick what is correct. If you

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