ear, nose, and throat doctors in corpus christi, tx - is there ...ear, nose & throat associates...

Yes No Is there anything that would prevent you from receiving a blood transfusion? If necessary, do you consent for a BLOOD TRANSFUSION? Yes No

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Page 1: Ear, Nose, and Throat Doctors in Corpus Christi, TX - Is there ...EAR, NOSE & THROAT ASSOCIATES of Corpus Christi Date:—] PATiENT*iSTORY Kidney Disease Liver Problem Lung Problem

Is there anything that would prevent you from recieving a blood transfusion? Yes NoIs there anything that would prevent you from receiving a blood transfusion?

If necessary, do you consent for a BLOOD TRANSFUSION? Yes No

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