Intake Form for Women with a History of Female Circumcision
Date Updated: February 27, 2015
2-page PDF example of intake form used to document patient history and exam as related to a history of female circumcision. PDF in sidebar.
Disclaimer: EthnoMed is designed for educational purposes only and is not rendering medical advice or professional services. Any medical decisions should be made in consultation with your doctors. Harborview Medical Center and UW Medicine will not be liable for any complication, injuries or other medical accidents arising from or in connection with the use of or reliance upon information on this website.