[Psychology] Ignacio Abraham Gorvell

[Ignacio Abraham]

I. PATIENT INFORMATION

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• Title: (select one)
  • [] Mr.
  • [] Mrs.
  • [] Ms.
  • [X] Other
  First Name:
  IGNACIO
  
  Middle Name: (optional)
  Sr.
  
  Last Name:
  ABRAHAM GØRVELL
  
  Gender: (select one)
  • [X] Male
  • [] Female
  Date of Birth:
  21/OCT/1980
  
  Address:
  Floor 2, Door 2, Elgin House, Morningwood, Los Santos, San Andreas
  
  ZIP / Postal Code:
  ANSWER
  

II. CONTACT INFORMATION

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• Phone Type: (select one)
  • [X] Mobile
  • [] Home
  • [] Work
  • [] Other
  Phone Number:
  98619369
  
  Email:
  [email protected] (( Ignacio Abraham ))
  

(( Discord: ))
lionvenom


III. APPOINTMENT DETAILS

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• Has the patient been seen at Pillbox Hill Medical Center in the past?
  • [X] Yes
  • [] No
  Does the patient have a diagnosis?
  • [X] Yes
  • [] No
  If so, please describe:
  Diabetes Mellitus Type I. Cataracts. (N/A if the answer to the previous question is 'No')
  
  Reason for Appointment: In my last medical visit, Dr. Okafor and I agreed that the recent weight loss is pathological. As a psychologist myself I recognise my issues and I am not above seeking a younger therapist for help.
  ANSWER
  
  Is this condition or injury related to work?
  • [] Yes
  • [X] No
  Is this condition or injury related to an auto accident?
  • [] Yes
  • [X] No
  Department:
  • [] Medical
  • [X] Psychology
  Dates & Times for Appointment: (list your available dates and times in the next 7 days - use more lines if needed and mark with an 'X' your preferred one. Note that we cannot guarantee exact scheduling, but we will do our best to accommodate the patient's wishes.)
  • [] Flexible schedule, seeking a native Norwegian speaking therapist.
  Preferred Doctor for Appointment: (check the list of doctors here and pick one based on personal preference. Note that this is optional and if you don't choose one, one will be automatically assigned to you.)
  Dr. Lyla Berg.