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Date Doctors Name Telephone Fax # Address City State Zip Dear Licensed/Certificated Professional: I have recently enrolled (or plan to enroll) in the Adapted PE/Adapted Aquatics class at Citrus College.
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Doctor's name is the name of the medical professional providing care.
Patients or their representatives are typically required to provide the doctor's name on medical forms.
To fill out the doctor's name, simply write the name of the doctor who is providing care for the patient.
The purpose of including the doctor's name is to identify the healthcare provider responsible for the patient's treatment.
The doctor's full name, credentials, and any other pertinent identifying information should be reported.
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