<?xml version="1.0" encoding="UTF-8" ?>
<XML_DIZ_INFO>
	<MASTER_PAD_VERSION_INFO>
		<MASTER_PAD_VERSION>3.01</MASTER_PAD_VERSION>
		<MASTER_PAD_EDITOR>PADGen 3.0.1.35 http://www.padgen.org</MASTER_PAD_EDITOR>
		<MASTER_PAD_INFO>Portable Application Description, or PAD for short, is a data set that is used by shareware authors to disseminate information to anyone interested in their software products. To find out more go to http://www.asp-shareware.org/pad</MASTER_PAD_INFO>
	</MASTER_PAD_VERSION_INFO>
	<Company_Info>
		<Company_Name>e-MedTools</Company_Name>
		<Address_1 />
		<Address_2 />
		<City_Town>Jackson</City_Town>
		<State_Province>Missouri</State_Province>
		<Zip_Postal_Code>63755</Zip_Postal_Code>
		<Country>United States of America</Country>
		<Company_WebSite_URL>http://www.e-medtools.com</Company_WebSite_URL>
		<Contact_Info>
			<Author_First_Name>Robert</Author_First_Name>
			<Author_Last_Name>Robinson</Author_Last_Name>
			<Author_Email>info@e-medtools.com</Author_Email>
			<Contact_First_Name>Robert</Contact_First_Name>
			<Contact_Last_Name>Robinson</Contact_Last_Name>
			<Contact_Email>info@e-medtools.com</Contact_Email>
		</Contact_Info>
		<Support_Info>
			<Sales_Email>info@e-medtools.com</Sales_Email>
			<Support_Email>info@e-medtools.com</Support_Email>
			<General_Email>info@e-medtools.com</General_Email>
			<Sales_Phone>+11111111111</Sales_Phone>
			<Support_Phone>+11111111111</Support_Phone>
			<General_Phone>+11111111111</General_Phone>
			<Fax_Phone>+11111111111</Fax_Phone>
		</Support_Info>
	</Company_Info>
	<Program_Info>
		<Program_Name>Multi-table new patient questionnaire</Program_Name>
		<Program_Version>1.0</Program_Version>
		<Program_Release_Month>02</Program_Release_Month>
		<Program_Release_Day>25</Program_Release_Day>
		<Program_Release_Year>2008</Program_Release_Year>
		<Program_Cost_Dollars>0</Program_Cost_Dollars>
		<Program_Cost_Other_Code />
		<Program_Cost_Other />
		<Program_Type>Freeware</Program_Type>
		<Program_Release_Status>New Release</Program_Release_Status>
		<Program_Install_Support />
		<Program_OS_Support>Win95,Win98,WinME,WinNT 3.x,WinNT 4.x,Windows2000,WinXP,Windows2003,Windows Vista Starter,Windows Vista Home Basic,Windows Vista Home Premium,Windows Vista Business,Windows Vista Enterprise,Windows Vista Ultimate,Windows Vista Home Premium x64,Windows Vista Business x64,Windows Vista Enterprise x64,Windows Vista Ultimate x64,Unix,Linux,Mac OS X,Mac OS X 10.1,Mac OS X 10.2,Mac OS X 10.3,Mac OS X 10.4,Mac OS X 10.5</Program_OS_Support>
		<Program_Language>English</Program_Language>
		<Program_Change_Info />
		<Program_Specific_Category>Home/Hobby</Program_Specific_Category>
		<Program_Category_Class>Home &amp; Hobby::Health &amp; Nutrition</Program_Category_Class>
		<Program_System_Requirements />
		<File_Info>
			<File_Size_Bytes>667791</File_Size_Bytes>
			<File_Size_K>652</File_Size_K>
			<File_Size_MB>0.64</File_Size_MB>
		</File_Info>
		<Expire_Info>
			<Has_Expire_Info>N</Has_Expire_Info>
			<Expire_Count />
			<Expire_Based_On />
			<Expire_Other_Info />
			<Expire_Month />
			<Expire_Day />
			<Expire_Year />
		</Expire_Info>
	</Program_Info>
	<Program_Descriptions>
		<English>
			<Keywords>health care questionnaire, new patient form, clinic form</Keywords>
			<Char_Desc_45>Free Multi-table new patient questionnaire</Char_Desc_45>
			<Char_Desc_80>Free Multi-table new patient questionnaire</Char_Desc_80>
			<Char_Desc_250>The FREE gray multi-table Health Care Consumer Questionnaire is a comprehensive medical history form designed to be filled out by the health care consumer prior to a visit with a health care provider.  </Char_Desc_250>
			<Char_Desc_450>The FREE gray multi-table Health Care Consumer Questionnaire is a comprehensive medical history form designed to be filled out by the health care consumer prior to a visit with a health care provider.   This MedicalTemplate is appropriate for a new patient evaluation or any visit to a health care provider.</Char_Desc_450>
			<Char_Desc_2000>The FREE gray multi-table Health Care Consumer Questionnaire is a comprehensive medical history form designed to be filled out by the health care consumer prior to a visit with a health care provider.   This MedicalTemplate is appropriate for a new patient evaluation or any visit to a health care provider.

The Health Care Consumer Questionnaire is a detailed 8-page snapshot of an individual’s current and past medical problems. 

Information included in the colorful table format Health Care Consumer Questionnaire

    * Allergies
    * Medications
    * Surgeries
    * Past Medical History
    * Family Medical History
    * Review of systems
    * Social History
    * Religious and cultural beliefs
    * Travel history
    * Occupational history
    * Carcinogen exposure history
    * Behavioral risk factors
</Char_Desc_2000>
		</English>
	</Program_Descriptions>
	<Web_Info>
		<Application_URLs>
			<Application_Info_URL>http://www.e-medtools.com/HCC_Questions_Grey.html</Application_Info_URL>
			<Application_Order_URL />
			<Application_Screenshot_URL>http://www.e-medtools.com/HCC_Gray.jpg</Application_Screenshot_URL>
			<Application_Icon_URL />
			<Application_XML_File_URL>http://www.e-medtools.com/HCC_G_PAD.xml</Application_XML_File_URL>
		</Application_URLs>
		<Download_URLs>
			<Primary_Download_URL>http://www.e-medtools.com/Health_Care_Consumer_G_v1.pdf</Primary_Download_URL>
			<Secondary_Download_URL />
			<Additional_Download_URL_1 />
			<Additional_Download_URL_2 />
		</Download_URLs>
	</Web_Info>
	<Permissions>
		<Distribution_Permissions />
		<EULA />
	</Permissions>
	<PADRING>
		<PADRING_FORM>Y</PADRING_FORM>
		<PADRING>http://www.e-medtools.com/medspelpad.xml

http://www.e-medtools.com/profilemdpad.xml

http://www.e-medtools.com/copd2pad.xml
 
http://www.e-medtools.com/copd1pad.xml
 
http://www.e-medtools.com/asthmapad.xml
 
http://www.e-medtools.com/cchosp.xml
 
http://www.e-medtools.com/pulmclinic.xml
 
http://www.e-medtools.com/hospitalistfu.xml
 
http://www.e-medtools.com/imhospital.xml
 
http://www.e-medtools.com/imclinic.xml
 
http://www.e-medtools.com/sleeppad.xml

http://www.e-medtools.com/clinicfu.xml

http://www.e-medtools.com/HCC_PAD.xml

http://www.e-medtools.com/HCC_C_PAD.xml

http://www.e-medtools.com/HCC_G_PAD.xml

http://www.e-medtools.com/icufu.xml

http://www.e-medtools.com/ildeval.xml

http://www.e-medtools.com/pleuraleval.xml

http://www.e-medtools.com/pneumonia.xml

http://www.e-medtools.com/lungmass.xml</PADRING>
	</PADRING>
</XML_DIZ_INFO>
