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Football Health History Form Mobile App

This mobile application takes place of a football health form. It asks for the patients basic information name, address, birth date, etc. Then it asks various questions about health conditions. The application is very thorough and touches on everything.

  • Lendlease
  • The Cooperative
  • PG&E
  • oxy
  • Red Bull
  • Mirvac

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Take a peek inside the Football Health History Form Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Full Name

  • Ico date

    Birth Date

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    Age

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    Social Security Number

  • Ico multiline

    Address

  • Ico textbox

    Phone Number

  • Ico multiline

    Last School Attended

  • Ico multiline

    A.

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    B.

  • Ico multiline

    C.

  • Ico multiline

    D.

  • Ico statictext

    E.

  • Ico textbox

    1. HEART TROUBLE

  • Ico textbox

    2. ASTHMA

  • Ico textbox

    3. BACK TROUBLE

  • Ico textbox

    4. DIABETES

  • Ico textbox

    5. CONVULSIONS

  • Ico textbox

    6. PNEUMONIA

  • Ico textbox

    7. SINUSITIS

  • Ico textbox

    8. HEPATITIS/JAUNDICE

  • Ico textbox

    9. HIVES

  • Ico textbox

    10. MONONUCLEOSIS

  • Ico textbox

    11. MIGRAINE

  • Ico textbox

    12. KIDNEY TROUBLE

  • Ico textbox

    13. RHEUMATIC FEVER

  • Ico textbox

    14. PILONIDAL CYST

  • Ico statictext

    F.

  • Ico textbox

    1. Sprain or strain of:

  • ...and More!

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