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Patient Registration Information Name: Date of Birth: How do you like to be addressed? Marital Status: Race: African American Indian Asian Caucasian Hispanic Native American Other Decline to Provide

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What is wwwepic-carecom?

wwwepic-carecom is a website for accessing healthcare resources and services.

Who is required to file wwwepic-carecom?

Healthcare providers and facilities are required to file wwwepic-carecom.

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What is the purpose of wwwepic-carecom?

The purpose of wwwepic-carecom is to collect data on healthcare providers and facilities.

What information must be reported on wwwepic-carecom?

Information such as provider/facility details, services offered, and patient demographics must be reported on wwwepic-carecom.

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