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PATIENT IS LEGAL NAME: DATE: YOUNGSTOWN Orthopedic ASSOCIATES Bldg A 6470 TIPPECANOE ROAD, CANFIELD, OH 44406 Bldg B 1499 BOARDMANCANFIELD ROAD, BOARDMAN, OH 44512 www.youngstownortho.com CONFIDENTIAL
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How to fill out patients legal name date

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How to fill out patients legal name date:

01
Begin by writing the patient's full legal name in the designated space. Make sure to use the name that appears on their identification documents.
02
Next, provide the patient's date of birth, writing it in the correct format (mm/dd/yyyy).
03
Double-check that all the information is accurate and spelled correctly before submitting the form.

Who needs patients legal name date:

01
Healthcare providers: Doctors, nurses, and other healthcare professionals need the patients' legal name and date of birth to accurately identify them and ensure they receive the right medical care.
02
Insurance companies: These organizations require the patients' legal name and date of birth to verify their identity and process claims correctly.
03
Legal authorities: In certain situations, such as legal proceedings or public health emergencies, legal authorities may require the patients' legal name and date of birth to establish their identity and facilitate necessary actions.
Remember, providing the patients' legal name and date of birth accurately is crucial to ensure their safety, privacy, and appropriate medical attention.
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The patient's legal name date is the date on which the patient's legal name was recorded or changed.
The healthcare provider or institution where the patient was seen or treated is typically required to file the patient's legal name date.
The patient's legal name date can be filled out by entering the date on which the patient's legal name was officially recorded or changed.
The purpose of the patient's legal name date is to accurately identify the patient and ensure proper documentation of their legal name.
The information reported on the patient's legal name date typically includes the date on which the legal name was recorded or changed.
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