CLIENT INFORMATION & MEDICAL HISTORY In order to provide you with the most appropriate treatment, we need you to complete the following questionnaire. All information is strictly confidential. PERSONAL INFORMATION Client

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Curriculum Vitae Carolina Vera University of Buenos Aires-CONICET Argentina Personal Information

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• Climatology
• Physical geography
• Meteorology
• Climate change
• Global warming
• Climate history
• Climatologists
• Intergovernmental Panel on Climate Change
• United Nations Environment Programme
• Vera
• Kevin E. Trenberth
• Climate

FAIR CREDIT REPORTING ACT NOTIFICATION (Required use under Section 604(b) of the FCRA)

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• Credit
• United States federal banking legislation
• Personal finance
• Fair Credit Reporting Act
• Credit bureau
• Credit history
• Credit score
• Consumer
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DO NOT WRITE ON THIS FORM. USE IT TO MAKE COPIES. Personal Medical History (Please complete a form for each member of your family.) Name: ______________________________________

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• Economy
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• Payment systems
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• Credit score
• Debit card
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Woman Looking Over a Bank Statement

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• Economy
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• Credit history
• Credit score
• Credit bureau
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• Credit card
• Equifax
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• Economy
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• Debt
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PERSONAL HISTORY 1935 Born, London, England to Mark and Esther Cohen

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