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DEMOGRAPHIC DATA FORM UC DAVIS HEALTH SYSTEM (8×10) EMPLOYEE NAME (LAST, FIRST, MIDDLE INITIAL) DEPARTMENT / COST CENTER As a Federal contractor, the University of California is required to collect
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How to Fill Out UC Davis Health System:

01
Start by visiting the UC Davis Health System website or calling their office to obtain the necessary forms.
02
Provide your personal information, including your full name, address, phone number, and email address.
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Fill out the insurance section, which may require you to enter your insurance carrier's name, policy number, and any applicable group numbers.
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If you are a new patient, complete the medical history section by providing details on your past and current medical conditions, surgeries, medications, and allergies.
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If you have any preferred healthcare providers within the UC Davis Health System network, list them in the appropriate section.
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Review the forms carefully to make sure all information is accurate and up-to-date before submitting them.
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Submit the completed forms either in person, by mail, or through the UC Davis Health System's online portal, if available.

Who Needs UC Davis Health System:

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Students and staff of the UC Davis campus who require medical or healthcare services can benefit from UC Davis Health System.
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Patients seeking specialized medical care, such as cancer treatment, cardiovascular care, or organ transplants, may choose UC Davis Health System for its expertise in these fields.
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Residents of the surrounding community who are in need of primary care, specialty care, or emergency services can utilize UC Davis Health System as a comprehensive healthcare provider.
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