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St. Francis Urology1516 SW 6th Ave, Ste 1 Topeka, KS 66606 Phone: 7852321005 Fax: 7852322564REFERRAL FORMREFERRAL DATE: REFERRAL DIAGNOSIS: PATIENT INFORMATION FIRST NAME: LAST NAME: DOB: PHONE NUMBER:
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How to fill out francis urology

01
To fill out Francis Urology form, follow these steps:
02
Start by gathering all the necessary information like personal details, medical history, insurance information, etc.
03
Visit the Francis Urology website or clinic and find the form online or request a physical copy.
04
Make sure to read the instructions carefully before starting to fill out the form.
05
Begin filling out the form by entering your personal information such as name, address, contact details, etc.
06
Provide accurate medical history including any previous surgeries, medications, allergies, or existing conditions.
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Fill in the insurance information accurately if applicable.
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Review the completed form to ensure all the information is correct and legible.
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Submit the filled-out form either by mailing it to the designated address or by submitting it online as instructed.
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If you have any questions while filling out the form, contact Francis Urology for assistance.
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After submitting the form, keep a copy for your records.

Who needs francis urology?

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Francis Urology is needed by individuals who require urological care and treatment.
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This may include people who have urinary tract infections, kidney stones, prostate issues, bladder disorders, urologic cancers, or any other urological conditions.
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Both males and females of different age groups can seek the expertise of Francis Urology.
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It is also beneficial for individuals who need routine check-ups, consultations, or specialized treatments related to urology.
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If you believe you have a urological issue or need expert advice in this field, Francis Urology can provide the necessary care and treatment.

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Francis Urology is a medical practice specializing in the diagnosis and treatment of urinary tract and reproductive system disorders.
Physicians, healthcare providers, or medical facilities associated with Francis Urology are required to file the necessary documentation.
To fill out Francis Urology forms, medical providers need to input patient information, diagnosis details, treatment plans, and any relevant medical history.
The purpose of Francis Urology is to provide high-quality medical care to individuals with urological issues.
Information such as patient demographics, medical history, diagnosis, treatment plans, and follow-up care details must be reported on Francis Urology forms.
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