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MrsMissMsSurnamePlease complete in BLOCK CAPITALS and tickGMS1 as appropriateTelephone cumbersome of previous doctor at that addressLiverCorneasLungsPancreasAny part of my body HA Reenlistment dateSignature
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To fill out the name of your previous doctor, follow these steps:
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Locate the section for previous medical information on the form.
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Find the field designated for the name of your previous doctor.
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Enter the full name of your previous doctor as accurately as possible.
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Who needs name of previous doctor?

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Several situations may require you to provide the name of your previous doctor, including:
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- Patients who are switching healthcare providers or physicians.
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- Individuals who have recently moved and are seeking medical care in a new location.
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- Patients who are participating in clinical trials or research studies.
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- Individuals who have had a change in insurance and need to update their medical records.
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- Patients who are seeking a second opinion from a different healthcare professional.
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In these cases, providing the name of your previous doctor ensures continuity of care and helps the new healthcare provider better understand your medical history.
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The name of the previous doctor is Dr. Smith.
Patients who are switching to a new doctor are required to report the name of their previous doctor.
Patients can fill out the name of their previous doctor on the new patient registration form.
The purpose of reporting the name of the previous doctor is to provide continuity of care and allow the new doctor to review past medical history.
The name of the previous doctor and any relevant medical records or history should be reported.
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