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New Patient Registration Information Page 2 Prior Surgeries (check all that apply): Appendix Bladder Breast, Lumpectomy Breast, Mastectomy Colon, Diverticulitis

How to fill out new patient registration page

How to fill out new patient registration page

1. Open the new patient registration page on the website.
2. Find the required fields marked with asterisks (*) and provide the necessary information.
3. Start with entering your personal details such as name, date of birth, and contact information.
4. Move on to providing your medical history, including any allergies or pre-existing conditions.
5. Fill in the insurance information if applicable.
6. Choose a username and password for your account on the registration page.
7. Review all the entered information to ensure accuracy and make any necessary corrections.
8. Submit the registration form on the page.
9. Wait for a confirmation message or email indicating successful registration.
10. If any additional documents or paperwork are required, follow the instructions provided.

Who needs new patient registration page?

1. New patients who have never received services from the healthcare provider before.
2. Individuals who are seeking medical care, diagnosis, or treatment from the healthcare provider.
3. People who want to establish a patient-doctor relationship with the healthcare provider.
4. Patients who wish to have their medical and personal information on record at the healthcare provider's office.
5. Anyone who wants to access online features, appointments, or medical history through the provider's patient portal.

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