Health Evaluation & Rehabilitation Optimization

Veteran Health Data

Veteran Name

Age

Gender

Branch of Service

Years of Service

Rank at Discharge

Resting HR

BP (mmHg)

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Weight (kg)

Height (cm)

Current Activity Level

Recovery Status

Sleep Quality

Stress Level

Current Symptoms/Concerns

General Medical History (Non-service related)

Deployment History

Combat Exposure

Typical Weekly Exercise (minutes)

Dietary Habits

Social Support System

Chronic Pain Assessment

Home Environment/Accessibility

Service-Related Injuries/Conditions

Mental Health History

Current Medications

Chronic Conditions

VA Disability Rating (%)

Short-term Rehabilitation Goals

Long-term Rehabilitation Goals

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