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Medical Park West 8150 SW SR 200 Ocala, Florida 34481 To Schedule: pH: 8679606, option 2 Fax: 6223795 Advanced Imaging Centers PET×CT Exam Request Patients Name: Phone: Date of Birth: Clinical Indication
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How to Fill Out Medical Park West Advanced:

01
Start by obtaining the necessary forms from the designated source. These forms may be available online, at the medical park's reception desk, or through your healthcare provider.
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Review the forms carefully, ensuring that you understand the information requested and the purpose of each section. If you have any questions, don't hesitate to seek clarification from the medical park's staff or your healthcare provider.
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Begin by providing your personal details accurately. This typically includes your full name, date of birth, address, contact information, and insurance details if applicable.
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Move on to the medical history section. Here, you will need to provide information about any pre-existing medical conditions, allergies, current medications, and previous surgeries or hospitalizations. Be thorough and make sure to include all relevant details.
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If you have any specific preferences or requirements for your medical care, make sure to note them in the appropriate section. This may include requests for a specific healthcare provider, any language or communication preferences, or any other relevant details about your preferences.
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Finally, review the filled-out form for any errors or omissions. Make sure all the information provided is correct and complete. If necessary, consult with a healthcare professional or staff member at Medical Park West Advanced to ensure the accuracy of your form.
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Once you are satisfied with the completed form, submit it to the designated recipient at Medical Park West Advanced. Follow any additional instructions provided, such as making a copy for your records or scheduling an appointment.

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Medical Park West Advanced is a healthcare facility that provides specialized medical services and advanced treatments.
Medical Park West Advanced is required to file by healthcare providers who are affiliated with the facility.
Medical Park West Advanced can be filled out online through the facility's designated portal or submitted via mail.
The purpose of Medical Park West Advanced is to collect and report data on medical services provided by the facility for regulatory and compliance purposes.
The medical services provided, patient demographics, treatments administered, and outcomes must be reported on Medical Park West Advanced.
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