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DAVIS EYE CARE & OPTICAL REGISTRATION FORM TODAYS DATE: SECTION I: PATIENT INFORMATION NAME: MAILING ADDRESS: CITY: STATE: ZIP: STREET ADDRESS (IF DIFFERENT FROM MAILING ADDRESS): HOME: () CELL: ()
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Davis Eye Care AMP is a report used to provide information about eye care services provided by Davis Eye Care.
All eye care providers who work at Davis Eye Care are required to file the Davis Eye Care AMP.
Davis Eye Care AMP can be filled out electronically or on paper. The form must be completed with accurate information about the eye care services provided.
The purpose of Davis Eye Care AMP is to track and report the eye care services provided by Davis Eye Care in order to ensure proper documentation and billing.
Information such as patient demographics, services provided, dates of service, and billing codes must be reported on Davis Eye Care AMP.
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