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NEXT LEVEL URGENT CARE PREFERRED PHYSICIAN PROGRAM APPLICATION BASIC PRACTICE INFORMATION Name: Street: Type of practice: City: State: ZIP Code: Phone: Website: STAFF INFORMATION PHYSICIANS Name:
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How to fill out Next Level Urgent Care:

01
Visit the Next Level Urgent Care website or go to one of their physical locations.
02
Provide your personal information including your name, address, phone number, and date of birth.
03
Fill out any required medical history forms, detailing any pre-existing conditions or allergies.
04
Present your insurance information, if applicable, to ensure proper billing.
05
If you do not have insurance, Next Level Urgent Care provides affordable self-pay options.
06
Check-in at the front desk and wait to be called back to see a medical professional.
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Answer any questions or provide any additional information necessary when speaking with the medical professional.
08
Follow any instructions given by the medical professional and provide any necessary samples or specimens if requested.
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Upon completion of your visit, Next Level Urgent Care will provide any necessary paperwork or prescriptions.

Who needs Next Level Urgent Care:

01
Individuals who require immediate medical attention for non-life-threatening conditions.
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Those who are unable to see their primary care physician in a timely manner.
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Individuals seeking prompt medical attention during evenings, weekends, or holidays.
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Those who prefer the convenience and accessibility of urgent care compared to emergency rooms.
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People in need of routine healthcare services such as flu shots, vaccinations, or physicals.
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Individuals with minor injuries or illnesses such as sprains, burns, minor infections, or cold and flu symptoms.
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Next Level Urgent Care is a medical facility that provides immediate care for non-life-threatening illnesses and injuries.
Patients who visit Next Level Urgent Care are required to provide their personal and insurance information.
Patients can fill out Next Level Urgent Care forms either in person at the facility or online through their website.
The purpose of Next Level Urgent Care is to provide convenient and fast medical care for minor health issues.
Patients must report their symptoms, medical history, and insurance information when visiting Next Level Urgent Care.
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