Comprehensive Nutritional Assessment Support
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Requisition Summary:
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1. Age of the patient?
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2. Below 18 years
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3. Over 18 years
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4. Any other (please specify)
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6. Service type you are looking for?
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7. Nutritional assessment
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8. Other (please specify)
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10. Patient preferences for service delivery
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11. Consultation through health plan
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12. Self-paying customer
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14. Health insurance card details
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15. Cartão de todos
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16. Other (please specify)
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18. Are you following a special diet or nutritional program at present?
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19. Patient with Trastorno Especto Altismo (TEA)
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20. Diabetes Mellitus
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21. Hypertension
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22. Obesity
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23. Other (please specify)
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25. Preferred location for service delivery
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26. Consultorio do nutricionista
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27. Online service (non-presential)
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29. How often would you like to receive the service?
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30. Once-off session
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31. Regular sessions (schedule as per your preference)
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32. As and when required
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34. What is your preferred time for the sessions?
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35. Manhã
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36. Tarde
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37. Noite
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39. When do you need this service?
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40. Urgent (within the next 24 hours)
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41. Non-urgent (at your convenience)
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43. What matters most to you in terms of service quality?
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44. Quality over price
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45. Price over quality
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49. Would you prefer to have recommendations from our professional team?
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50. Yes, I would like to receive recommendations
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51. No, thank you. I'll manage on my own
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53. Is there any additional information we can use to improve our services?
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54. Yes, please provide additional information
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55. No, everything is fine
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56.