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Patient Information Name: (first) (initial) (last) Male (preferred name) Female Street Address: City: State: Date of Birth: Age Home Phone: Zip: Social Security # Marital Status Work Phone: Cell Phone:
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Initial is the first report or form that needs to be filed.
Individuals or entities meeting certain criteria set by the governing body are required to file an initial report.
The initial report can usually be filled out online or submitted in hard copy with all the required information.
The purpose of the initial report is to provide the governing body with important information about the individual or entity filing.
The information that must be reported on the initial form typically includes personal or business details, financial information, and any other relevant data.
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