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Orthopedic Central Intake Patient Information Sheet. You have been referred by your family doctor to Orthopedic Central Intake for an appointment with an orthopedic surgeon. There are some things

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How to fill out patient intake info sheet

01

Step 1: Begin by gathering all the necessary information including the patient's personal details such as name, date of birth, address, and contact information.

02

Step 2: Next, proceed to collect the patient's medical history including any past illnesses, surgeries, allergies, and current medications.

03

Step 3: Record the patient's family medical history, noting if there are any hereditary diseases or conditions that may be relevant.

04

Step 4: Ask the patient about their lifestyle habits such as smoking, alcohol consumption, and exercise routine.

05

Step 5: Document the reason for the patient's visit, noting any symptoms or specific concerns they may have.

06

Step 6: Inquire about the patient's insurance information, including their policy number and coverage details.

07

Step 7: Ensure all the collected information is accurate and legible before submitting the patient intake info sheet for further processing.

Who needs patient intake info sheet?

01

Patients visiting a healthcare facility for the first time.

02

Patients undergoing a new medical treatment or procedure.

03

Patients being admitted to a hospital or medical facility.

04

Patients seeking specialized or long-term care.

05

Patients participating in clinical research or trials.

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