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MAIN STREETPEDIATRICS 809 EAST MAIN STREET BLUE RIDGE, GA 30513 Phone: 7066320330 Fax: 7066329004 PATIENT INFORMATION DATE; Name: Sex: () M () F Address: Date of Birth: City, State, Zip: Social Security
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Start by filling out your personal information in the designated fields. This includes your full name, address, contact number, and email address.
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Who needs street pediatrics 809 east:
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Parents or guardians seeking medical care for their children.
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Families looking for a reputable pediatric clinic in the East area of the city or specific location.
Note: Please note that the specific reasons for needing street pediatrics 809 east may vary and are not provided in the given content.
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What is street pediatrics 809 east?
Street pediatrics 809 east is a form used to report information about pediatric services provided on the streets or in outreach settings at the address 809 East.
Who is required to file street pediatrics 809 east?
Pediatric healthcare providers who offer services on the streets or in outreach settings are required to file street pediatrics 809 east.
How to fill out street pediatrics 809 east?
To fill out street pediatrics 809 east, providers need to accurately report information about the pediatric services provided, including location, patient demographics, and types of services offered.
What is the purpose of street pediatrics 809 east?
The purpose of street pediatrics 809 east is to track and monitor pediatric healthcare services provided in outreach settings to ensure quality care for underserved populations.
What information must be reported on street pediatrics 809 east?
Information such as the location of services, patient demographics (age, gender, race/ethnicity), types of services provided, and the number of patients seen must be reported on street pediatrics 809 east.
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