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CORNWALL RADIATION ONCOLOGY SERVICES PROVIDERPATIENT CONTACT AND MEDICAL RECORDS RELEASE FORM CONSENT FORM I, DOB / / consent and agree that Dr Kay Han in addition, staff may contact me and leave
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How to fill out Cornwall Radiation Oncology services:

01
Visit the Cornwall Radiation Oncology website or contact their office to obtain the necessary forms.
02
Fill out personal information such as name, date of birth, address, and contact details.
03
Provide insurance information, including policy number and any relevant authorization or referral codes.
04
Indicate the reason for seeking radiation oncology services, whether it is for cancer treatment, post-surgical care, or supportive therapies.
05
Specify any previous medical history or conditions that may be relevant to the treatment, such as previous radiation therapy or surgeries.
06
If applicable, provide information about current medications, allergies, and any ongoing treatments or therapies.
07
Include any additional information or documentation that may assist the Cornwall Radiation Oncology team in understanding your specific needs or concerns.
08
Sign and date the form, acknowledging that the information provided is accurate and complete.

Who needs Cornwall Radiation Oncology services:

01
Individuals diagnosed with cancer who require radiation therapy as part of their treatment plan.
02
Patients who have undergone surgery and may benefit from post-surgical radiation therapy to prevent cancer recurrence.
03
Individuals seeking supportive therapies such as pain management or palliative care to improve their quality of life during cancer treatment.
04
Patients who have been referred to Cornwall Radiation Oncology by their healthcare provider or oncologist for specialized radiation treatments.
05
Individuals looking for advanced radiation technologies and treatment options that may not be available at other healthcare facilities.
06
Cancer patients who prefer a highly experienced and compassionate team that provides comprehensive care throughout their treatment journey.
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Cornwall Radiation Oncology Services is a medical facility that specializes in providing radiation therapy to cancer patients.
Patients who receive treatment at Cornwall Radiation Oncology Services may be required to file certain forms or documents related to their treatment.
Patients can fill out the necessary forms for Cornwall Radiation Oncology Services with the assistance of their healthcare provider or the staff at the facility.
The purpose of Cornwall Radiation Oncology Services is to provide radiation therapy treatment to cancer patients in order to help fight the disease.
Information such as patient's medical history, treatment plan, and any side effects experienced must be reported on Cornwall Radiation Oncology Services forms.
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