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I://PCC×Forms In House Referral Form 795 E. Second Street Pomona, CA 917662007 Main: 9097063900 Interdepartmental Referral Form Today's Date:
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How to fill out WesternU Patient Care Center:

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Begin by providing your personal information such as your full name, date of birth, address, and contact details. This information is necessary for the center to accurately identify and communicate with you.
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Next, you will be asked to provide your medical history. This includes any previous illnesses, surgeries, allergies, medications, and chronic conditions. It is important to be thorough and honest in this section as it will assist the healthcare professionals in understanding your medical background.
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You will also be required to fill out a section related to your insurance information. This involves providing details about your insurance provider, policy number, group number, and any other relevant information. This allows the center to determine the coverage and benefits applicable to your medical care.
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WesternU Patient Care Center may also ask for information regarding your emergency contacts. These contacts should be individuals who can be reached in case of an emergency or for important communication purposes.
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Additionally, you may need to fill out a section related to your preferred pharmacy and pharmacy contact information. This allows the center to send any prescriptions or medications directly to your chosen pharmacy for convenience.

Who needs WesternU Patient Care Center:

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Individuals who are seeking comprehensive healthcare services in a professional and reputable medical facility can benefit from WesternU Patient Care Center. The center offers a wide range of medical services, including primary care, specialty care, preventive care, and diagnostic services.
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Patients who require routine check-ups, preventive screenings, or treatment for acute illnesses can make use of WesternU Patient Care Center. The center is equipped with highly skilled healthcare professionals who provide personalized and evidence-based care to meet the individual needs of patients.
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People who are in need of chronic disease management or specialized care for specific health conditions can also benefit from WesternU Patient Care Center. The center offers specialized clinics and services, such as diabetes management, cardiology, dermatology, and gynecology, among others.
In summary, WesternU Patient Care Center offers comprehensive healthcare services to individuals seeking professional medical care. By accurately filling out the necessary forms and providing all the required information, patients can ensure a smooth and efficient experience at the center.

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