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PATIENT REGISTRATION AND MEDICAL HISTORY Date (PLEASE PRINT) Home Phone () Patient me Street Address City Email Sex Cell Phone fl V n r Age zip State () ! Married I Widowed f Single ! Minor f Separated

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What is please prtnt?

Please prtnt is a tax form used for reporting income, deductions, and credits for individuals.

Who is required to file please prtnt?

Individuals who have income that meets certain criteria set by the IRS are required to file please prtnt.

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Please prtnt can be filled out either manually or electronically depending on individual preference.

What is the purpose of please prtnt?

The purpose of please prtnt is to report income, deductions, and credits to determine the tax liability of an individual.

What information must be reported on please prtnt?

Information such as income from wages, investments, and self-employment, as well as deductions and tax credits, must be reported on please prtnt.

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