div class=ts-pagebuttonPage 1button div class=ts-image amp-img class=ts-thumb alt=Page 1: Patient History Questionnairewasatchpeakbrinksternet201505PatientHistorypdfChief Complaint Referring Doctor History of Present Illness or Injury Onset DateDate Symptoms src=https:reader034vdocumentinreader034viewer20220422225ec8f672a1e6465def38ca8ehtml5thumbnails1jpg width=142 height=106 layout=responsive amp-img divdiv