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Duke Children's and Wakened Children's Specialty Services Request for Consultation Fax referral to 9198621202 Date PAT I E N T D E M O G R A P H I C I N F O R M AT I O N Patient Name Duke/Wakened
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How to fill out Duke Children's and WakeMed:

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Start by gathering all necessary information such as personal details, medical history, and insurance information. Make sure to have any relevant documents or paperwork ready.
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Visit the official websites of both Duke Children's and WakeMed to find the required forms for patient registration. These forms are usually available in the "Patient Resources" or "Patient Registration" section.
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Download and print the forms or request them to be sent to you via mail if online submission is not available.
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Carefully read through the instructions provided on the forms to ensure you understand what information needs to be provided in each section.
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Begin filling out the forms, starting with your personal information, including your name, address, contact details, and social security number.
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Move on to the medical history section, where you may be asked to provide details about any existing medical conditions, past surgeries, medications, and allergies.
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Fill in the insurance information section, including your insurance provider's name, policy or group number, and any other necessary details. If you don't have insurance, indicate that on the form as well.
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Review all the filled-out information carefully to avoid any mistakes or missing details. Ensure that the forms are neatly and accurately filled out.
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If required, sign and date the forms at the designated places to certify that the information provided is true and accurate to the best of your knowledge.
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Once you have completed the forms, follow the instructions provided by Duke Children's and WakeMed on how to submit the forms. This might involve dropping them off in person, mailing them, or submitting them online.
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Make copies of the completed forms for your records before submitting them, so you have a record of the information provided.
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If you have any questions or need assistance while filling out the forms, contact the patient registration or admissions department of Duke Children's and WakeMed for guidance. They will be able to provide you with the necessary support.

Who needs Duke Children's and WakeMed?

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Individuals, especially children, who require specialized medical care and treatment from reputable hospitals.
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Patients seeking comprehensive healthcare services, including diagnostics, treatment, surgeries, and ongoing care.
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Families looking for medical centers with a multidisciplinary approach, combining advanced medical technology, specialized doctors, and a patient-centered care philosophy.
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People with various medical conditions or ailments that require the expertise of healthcare providers associated with Duke Children's and WakeMed.
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Individuals seeking access to a network of specialists, pediatricians, surgeons, nurses, and support staff focused on providing high-quality healthcare services for children and patients of all ages.
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Duke Children's and WakeMed are healthcare facilities that provide medical care for children and patients.
Patients, parents, legal guardians or authorized representatives are required to provide information for Duke Children's and WakeMed records.
Patients or their representatives can fill out Duke Children's and WakeMed forms either online or at the healthcare facility.
The purpose of Duke Children's and WakeMed is to maintain accurate medical records and provide quality healthcare services to children and patients.
Information such as personal details, medical history, insurance information, emergency contacts, and healthcare preferences must be reported on Duke Children's and WakeMed forms.
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