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CLEVELAND CLINIC Patient Registration Form: Children under the age of 16 only (persons 16 years and over to complete adult application form) Please complete clearly all relevant sections of this registration
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What is Patient Registration : CHILD Form?

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The patient registration form child is a form used to register child patients in a healthcare facility.
Parents or legal guardians of the child patient are required to file the patient registration form child.
The patient registration form child can be filled out by providing the child's personal information, medical history, emergency contact details, insurance information, and any other relevant information.
The purpose of the patient registration form child is to gather necessary information about the child patient for medical records and treatment purposes.
The patient registration form child must include the child's full name, date of birth, address, medical history, insurance information, and emergency contact details.
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