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New Patient Registration Application ADULT ONLY New patients need to complete a preregistration questionnaire and attend a new patient registration appointment. Please book an appointment for your

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How to fill out new patient registration application

01

Step 1: Obtain a new patient registration application form from the healthcare facility.

02

Step 2: Carefully read through the instructions provided on the form.

03

Step 3: Fill out your personal information such as name, address, contact details, and date of birth.

04

Step 4: Provide your medical history and any relevant information related to any existing conditions or medications.

05

Step 5: Attach any required documents such as copies of identification or insurance cards.

06

Step 6: Review the completed form for accuracy and completeness.

07

Step 7: Submit the filled application form to the designated person or department at the healthcare facility.

08

Step 8: Follow any additional instructions provided by the healthcare facility regarding further steps after submitting the application.

Who needs new patient registration application?

01

Any individual who wishes to become a new patient at a healthcare facility needs to fill out a new patient registration application.

02

This includes individuals who are new to the area, switching healthcare providers, or seeking specialized care.

03

The application helps the healthcare facility gather necessary information about the patient and ensures proper record-keeping and communication between the patient and the healthcare provider.

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