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College Park Family Care Center, P.A. Specialty Office FORM FEE GUIDELINES Date: Providers Name: Patient Name: Date of Birth: Patient/Guardian Contact Phone Number: Please READ and INITIAL the following
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College Park Family Care is a healthcare provider that offers a range of medical services to individuals and families.
Anyone who has received medical services from College Park Family Care and needs to report it for insurance or tax purposes.
You can fill out the College Park Family Care form by providing your personal information, details of the medical services received, and any insurance information.
The purpose of College Park Family Care is to document and report medical services received by individuals for insurance reimbursement or tax reporting purposes.
The information that must be reported on College Park Family Care includes the date of service, type of service received, healthcare provider's information, and any insurance details.
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