Get the free PATIENT REGISTRATION - proformancerehabcom
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Performance Rehab, Inc. PATIENT REGISTRATION Name: Today's Date: Address: DOB: Age: City: State: Zip Code: Home #: Work #: Cell #: Email: Employer: Occupation: Emergency Contact: Phone #: Reason for
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How to fill out patient registration - proformancerehabcom
How to fill out patient registration - proformancerehabcom:
01
Visit the website proformancerehab.com and navigate to the patient registration page.
02
Fill in your personal information, including your full name, date of birth, address, and contact details.
03
Provide your insurance information, such as the name of your provider and your policy number.
04
Answer any health-related questions, such as any pre-existing conditions or medications you are currently taking.
05
Review the information you've entered and make sure it is accurate and complete.
06
Submit the registration form.
Who needs patient registration - proformancerehabcom:
01
New patients: If you are visiting ProFormance Rehab for the first time, you will need to fill out the patient registration form. This ensures that the clinic has your complete and up-to-date information for record-keeping purposes.
02
Returning patients: If any of your personal or insurance information has changed since your last visit, it is important to update it by submitting a new registration form. This helps ensure that the clinic has the most accurate information on file for you.
03
Patients seeking specialized treatments: If you are seeking specialized treatments or services at ProFormance Rehab, such as physical therapy or chiropractic care, you may be required to fill out a patient registration form specific to that service. This allows the clinic to gather relevant information specific to your treatment needs.
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