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Balance Health & Injury Clinic, PC 1217 NE Burnside Rd, STE 301 Gresham, OR 97030 Today's date: PH 503.492.2625 B H I/N I Name: DOB: Gender: M F Reason for visit: When did your symptoms begin? Right
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How to fill out initial patient form rev:
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Start by gathering all necessary personal information, such as full name, date of birth, address, and contact details.
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Who needs initial patient form rev:
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Patients who haven't visited a particular healthcare provider in a long time may also be required to update their information by filling out the form again.
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